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The most useful advance in surgery is touted to be the absorbable stitch

From Diana J. Choyce
Mar 06 - 12, 2000

Advances in medical science and technology have been on a sharp incline in the past decade. Many of these ideas will be the seed for incredibly positive effects for man. Some will fall by the wayside as mere phases. I thought it would be interesting to see what "seeds" are rooting as of late.

Johnson & Johnson has been boasting the introduction of a "better Band Aid". This high tech band aid comes at a premium purchase of 10 for $3.79 US, but is billed as the biggest technological achievement since the company first launched the Band-Aid in 1921. The whole band aid is a moisture absorbent layer as opposed to the old model with the white pad in the middle. Doctors have long said that the key to helping skin cells grow new tissue, is keeping the proper amount of moisture around a wound. This band aid also has particles that absorb oozing from the wound and form a white gel that provides extra cushioning against re-injury.

From the same area as healing comes the use of a substance similar to Krazy Glue used to repair unhealed compression fractures of the spine. These breaks happen when the bones become weak and fracture due to osteoporosis, the most common bone disease. Osteoporosis is a debilitating disease characterized by low bone density that leads to bone fragility and an increase in the risk of fracture. The typical treatment for compression fractures of the spine is six to eight weeks of bed rest and painkilling narcotics. There have been few studies of this new non-surgical procedure, called vertebroplasty, in the United States. But early results are promising, according to Dr. Mary E. Jensen, director of neuroradiology at the University of Virginia Health Sciences Center in Charlottesville and a pioneer of the procedure in the United States. "This is the one procedure that I do that is really a miracle," says Jensen. Many of her patients report nearly instant relief, Jensen said. About 80 percent said they felt much less pain within 48 hours of the procedure. About 20 percent reported they stopped taking all pain medications, and about 35 percent said they went back to all the activities they did before the spinal fractures, according to a long-term follow-up study that has not yet been published. Vertebroplasty is new in the United States, but doctors in France have been doing a similar procedure for about 10 years. Using imaging equipment to guide them, doctors inject a long needle through the back into the fractured vertebra. Then they inject a quick-drying, medical-grade cement that flows into the cracks and fills in the gaps. The cement hardens in 15 minutes and reinforces the bone. The procedure, which can be done with a local anesthetic in a radiologist's suite rather than an operating room, takes about one hour, and patients usually walk out of the hospital.

The most useful advance in surgery is touted to be the absorbable stitch. A far better alternative than having to be sewed up and then going back in a week or so to have the stitches removed. According to the journal of Clinical Orthopedics, a new and similar technique is being studied to repair broken bones. The present method is to use metal screws to hold the bones together as they heal. Then after a few weeks the screws must be removed. However, a new device called a "biodegradable nail" that will hold the bones together is in research trials. So far, studies using sheep have shown that aside from minor local irritation, the nails work just as well as screws. And the added advantage is not having to undergo another painful procedure to remove them.

Another interesting advance is in the area of heart patient care via the internet. It is common knowledge that the sooner a heart attack is noted the quicker the response and the better chance for survival. But daily monitoring of patients can be both labor and cost intensive. Doctors are now implanting tiny monitors inside the hearts of 120 patients to painlessly record every twinge, 24 hours a day. Sit in front of a doctor's wireless transmitter and the monitor beams the recordings into a computer for diagnosis. But by spring, the study's participants won't have to leave home, instead spending five minutes a day beaming their Chronicle heart monitor's recordings to a doctor's secure Web site via a telephone line. "We believe it's the next generation of care,'' says Michael Colson of Medtronic Inc which is developing the experimental Chronicle system. "This is the future for chronic disease management of heart failure, diabetes, and asthma,'' adds Dr. Richard Miller, director of the Mercy Heart Institute in Sacramento, Calif., who is using a simpler online monitor, the Health Buddy. Medtronic's Chronicle is the more sophisticated technique which allows surgeons to thread the pacemaker-like device into the heart, to measure pressure and other subtle disease signs that until now only in-hospital cardiac catheterizations could provide. For now, weekly doctor visits download the recordings, which can alert if a medication change is needed before there's a crisis. Medtronic hopes to ship patients at-home transmitters by spring. They will be able to point the antenna at their chest and the recordings beam over a phone line to the doctor. Patients seem very excited by this new advance which allows them far more freedom in movement and from worries. "You'll be in touch with these people anywhere in the country,'' said implant recipient Edward A. Krzyston, 51, of Hammond, Ind., who's looking forward to vacationing with his device, and says he'll no longer wonder if he's imagining symptoms. "You don't want to sound like a whiner. With this device, it just records the information and the doctor decides if it's important or not.'' If studies prove the device effective, Medtronic hopes to apply for FDA approval in about two years.