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ukraine and volunteers everything is possible everything will find everyone feed everyone tails will be saved give them a gift for airplanes they collect for doctors, they help the lullaby, they sing the lullaby, they equip everyone, they hug, glory to ukraine to the whole world, ukraine is glorified by the volunteer family, there is no translation all of ukraine thanks you how to get help on accommodation for internally displaced persons you have moved from the territory located in the area of ​​hostilities or are under temporary occupation receive accommodation assistance in the amount of two thousand hryvnias or 3,000

hryvnias for persons with disabilities and children assistance can also be received by people whose housing is destroyed or unsuitable for living due to damage to the details on the site vyrav.org.ua i have influence, i congratulate you, i'm iryna koval, and this is a program about health during the war in the recent past. we even they could not imagine that such a thing is possible, and i am not talking about the war now, i am talking about the rapid development of technologies that today allow people to return to a full life from seemingly hopeless situations, war, every day we learn about dozens of

wounded as a result of shelling, and a continuous stream of civilians and military people are coming to hospitals, mostly this complex injuries of the limbs and skull often occur among patients, and their children have a whole life ahead of them, but the war made its corrections and, even relatively recently, severe injuries remained in a person forever limiting movements and poisoned life with feelings of doom and despair, but today everything is different . patients crippled by shelling can be saved. today, technologies allow us to restore lost body fragments, they are replaced with implants printed by a laser printer, so now a complex injury is not a sentence for life, but a work process for a number of specialists , these are doctors, engineers and 3d operators print and today we want to tell you about something that you probably did not know, such complex operations are performed

here in ukraine and implants are used at the same time ukrainian manufacturer, so now there is no need to go abroad for treatment, its duration and cost in our country are much lower, we will show you how titanium prostheses are created for surgical operations and what opportunities this unique print gives to ukrainian doctors and especially patients and now i want to introduce you to our guest and to contact us, candidate of medical sciences and doctor-orthopedic-traumatologist- oncologist, this is oleksandr haluzynskyi, mr. oleksandr. i welcome you, friends, and i want to say a few more words about you so that our viewers know that you have more than 20 years of surgical experience and for some of the last 10 you specialize in endoprosthetics , i.e. joint replacements. and this is one of the first surgeons who started using

individual 3d printed implants in practice, so oleksandr, let's tell you more about this and our viewers will firstly ask about what kind of cases and injuries you most often have to deal with in wartime, and now during the war there are a lot of patients who are brought to medical institutions from me with explosive and gunshot wounds, it is clear that there are still defects that occur during the wound, they lead to the invalidation of patients, fortunately , now there are technologies that allow these defects to be filled with titanium, the design is carried out by an engineer and in our in ukraine, our country already has e-e titanium laser printers

that allow you to print such implants immediately after an injury, such surgical interventions cannot be performed because most e-e gunshot wounds are infected as as a rule, you have to wait a few weeks or even a few months after the body has overcome the infection and then perform a reconstructive operation in order to put an endoprosthesis . about the fact that we have wounded not only military personnel, but also civilians as a result of shelling and bombing, god, many of them are in city hospitals and military towers, and in the institute cars orthopedics, traumatology and even the cancer institute

bring such patients, not all patients can be sent for treatment abroad, where such surgical interventions have been carried out for a long time. well , today there is no need for this anymore . about the 3d-printer and the creation of titanium endoprostheses in ukraine, too. our film crew saw with their own eyes how these endoprostheses are made. we would like all ukrainians to see it, because our nataliya shumak visited the production and we now we want to show all the viewers the intricacies of this unique process, how fragments of the human body are made from metal, let's see further in the story orbit of the eye, which replaces the lost e part of the bone at the e-e bottom of the eternal cavity, extreme plates

that replace skull defects of large, small, different sizes, this is it at first glance ironic for someone, without exaggeration, saving lives and the only hope for restoring health is titanium prostheses, they restore lost bone fragments in surgery, in fact, this is quite new technology, that is, the first such implant printed and delivered to a person was in 2008 in italy, and such patients with such complex defects, until now, they had no alternative at all, well , there were certain alternatives, but for those who did not have it, they simply remained a-a disabled for the rest of his life, yaroslav studied and worked in estonia for several years and mastered 3d metal printing with the gained experience returned home and in 2020 began manufacturing titanium prostheses in ukraine certified company the first in

in ukraine, everything is happening here. this is the same laser 3d printer that prints prostheses. the equipment is not cheap. its cost reaches about a million us dollars. on this platform, on this plate, it happens directly. printing is a painstaking process and can last up to three hours. the material is prepared in parallel, and the material is titanium powder, from which the friend himself passes directly. the titanium alloy is used only certified for medical use. it is bought in canada and in order not to waste time on delivery, we order a six-month supply in advance before using it, we must dry it, sift it, and only

after these operations we use it in a friend. the future fragments of the human body appear. right now we are printing with this the strips that you see on the screen , that is, here is one end plate three acetabular cups of the hip joint eh and one augment to eh knee endoprosthesis, a friend of these products will last 26 hours. approximately together with the implants, the printer prints special test samples to check the quality of the batch. the batch number is printed on top. they are torn on a tearing machine and we determine the strength and in the same way test whether the strength of the manufactured products corresponds to a specific batch. with the requirements we set for these products , 200 implants were produced here in two years, although the capacities are much

higher, on average, they are somewhere around 900-1000 this one printer can print prostheses in a year. but among the thousands of printed samples, there will not be the same ones, because each product is unique, each implant is unique, what makes it unique is that it is designed for the patient, that is, it is suitable only for this patient and only for his specific defect, for his anatomical features, such individual endoprostheses accurately repeat the patient's bones. and this is extremely important, for example, in maxillofacial surgery, because in addition to the patient's health, the plates will also restore his appearance we have an individual jaw, and we can make different products, what is it for facial surgery , such as half jaws, jaw plates, eye orbits of various types, and such things, the demand for production has changed, they say that before we received orders

mostly for small implants for planned operations, now there is a need for large ones bone fragments for those wounded as a result of shelling, if there are large prostheses. previously, there were several a year, but now their fate has increased a little, this is the replacement of osteosarcoma, if i remember correctly, but just by the way, such similar prostheses can now be used to replace defects of tubular bones in which titanium endoprostheses of ukrainian production obtained in the event of explosive injuries have a number of advantages compared to foreign ones. abroad, why in 1.5-2 because, well, according to the prices , it can be 20 dashes 50% cheaper there. but if you also take into account customs clearance and delivery, plus the terms here, well, twice as fast, we

can definitely do it here in ukraine, it is better to deliver the product than if to bring it from abroad, the war pushed the company to a new direction in the production of printing prostheses for animals, because four-legged dogs rarely become victims of russian aggression, these are the implants we made for a-a dogs for one dog that was injured if i remember correctly , in mariupol from of combat operations, that is, she has such limb prostheses, which titanium rods are inserted into the bone, and from the outside, such boots are put on them. she can use them as paws and walk fully. that is, at the same time the prosthetics of two paws were performed for the first time in ukraine in may, and during and after the prosthetics, the

patient feels good and has already gotten used to the new iron paws, mr. oleksandr, the story about all this is very interesting. i am very pleased that we ukrainians have finally learned to create these implants and we don't need to go anywhere abroad for such treatment and replacement, let's say, of certain organs that we will need, and in general, this story is very revealing and very necessary because now there is also a war in our country. i understand that you started creating all this long before the war. it is absolutely true. we started using such technologies for patients with loose endoprostheses. the loose endoprosthesis causes a

large defect in the surrounding bone tissue. with a disabled person well, namely, a promising , interesting direction for us. the ending p alexander well, i understand that this is how we saw in our plot the work of not one person, but a whole company of people, and this requires a lot of technology, and this story was interesting about the dog mozart, and a little later we will learn about another story of a person who also lives with a ukrainian-made titanium implant. but first, it is worth saying that the production begins long before the printing of the implants, it begins with the design of the model, and for this, the patient is subjected to a

computerized tomography scan in the hospital, the images are sent to bioengineers and designers, and they, in turn , create a 3d model of the future implant. and only then this model is transferred to production. the future of implants and who does it, we will also . now i want to find out, i want to introduce one more person who will be in touch with us, this is a bioengineer svitlana er burburska lady svitlana i know you too welcome to our broadcast today, welcome to you ms. svitlana so, i want to ask you how long is the process of creating these projects of yours exactly how it will be called correctly it will be called a model is it some kind

of special scheme what is it uh in the final version we get exactly model, but why does such a long design take place because , in addition to the implant itself, we design the operation together with the surgeon, that is, we analyze these ct data that we have and create a 3d model based on them and then we print this 3d model on a plastic 3d printer and the surgeon can get acquainted with it live, that is, he can hold it in his hands and see the defect that is inside the person , because the model comes out one by one, well, one by one, according to the scale, he can evaluate this defect is and he communicates with the engineer and we decide what exactly we will do, we take into account the full anatomy of the individual anatomy of the patient, we take into account access to the surgical room, which doctor will go, we take into account, including what tools he will use it, then we

print our previously created model on a 3d printer again, then everything is tried on if the doctor wants to make some references. of the implant itself. we also design, for example, tools that help to correctly perform the resection, correctly direct the drills, and everything else . secondly, it is faster because the doctor is already going to the operation. he understands how step by step he will use what he will do, and besides, he has already done it all in his own office, roughly speaking, on the plastic prototypes of ms. svitlana. please tell me, this design is directly yours how long does the work take, well , three weeks - this is the minimum due to the fact that we are making

corrections together with the doctor, but we will try to speed it up, and roughly speaking, in ukraine , there are currently not enough people who, uh, have uh, knowledge and experience in this field, so we will develop in this direction so that more of our people are ukrainian specialists, and in this way, most likely, we will be able to speed up design and, accordingly, production, including mrs. svitlana, you are talking about the fact that there are not enough people , why are there not enough people that they don't train for such a profession, or do you need to study on your own , go somewhere abroad, what's the matter? i understand that such specialties are only just beginning to appear. why, because this technology is really new, as already mentioned, the first implant was placed only in 2008, and accordingly, an engineer gains experience primarily during work and communication with surgeons, because each end, well, each bone is a specific anatomy, specific

surgery, tools and everything else is therefore completely the whole complex. well, it is unlikely that you can learn this at a university, rather you have to study in specialized schools such as these laboratories where there are already people with experience in this work, mr. oleksandr, i want to ask you if it is possible to do in advance, any predictions as to whether this implant will take root, and in the vast majority of cases , these implants are used because they are made of medical titanium, and preparation of the patient is very important for this, as i have already said, if we are talking about gunshot wounds, and the first issue is the struggle with an infection, special tests, special analyzes give an answer to whether the patient is ready for such an operation, and in general, how much time should pass after the operation in order to understand

that everything is fine, and how long the recovery period lasts the period directly a-a each time e-e is decided individually a-a the most important the most important period is before the stitches are removed if suppuration does not occur during the first two weeks, this is already a good e-e prognosis, sometimes there are rarely so-called late suppurations that can take place a few months after the operation. but fortunately, they happen quite rarely. we are talking about individual 3d printed endoprostheses. we are talking about the fact that this prosthesis is made directly. that is, it is not some kind of blank, but this prosthesis is made directly for each person, for their needs, taking into account what their body constitution is, what their weight

is. and all the irregularities of the bone are completely repeated by the individual implant, in this case this technology is unique and has no analogues, precisely because it is a personalized individual implant that repeats the geometry of the bone that's exactly why we have such good results and such hope for the future for such patients, oleksandr , can you say how many patients have already been operated on and helped so far in ukraine, it's hard to say, but at least our laboratory, which is engaged in the design of such implants , has just as for the hip joint, more than 250 implants have already been designed

. half of the pelvis and the second femur did you have such operations correct absolutely correct yes and it allowed in both cases to do without amputation that is, you can say that you not only save people's lives, but also improve them. to notice large bone defects, small defects can be filled a-a hello bone or out bone with special fabulous-plastic materials, but if we are talking about replacing a large defect over 25 cm, only a titanium individual implant can help the patient understands, and i would like now that we

add another person to our broadcast. she used to live an ordinary life and was involved in sports. but one day she felt pain in her leg. this is how the story of the illness and rescue of the ukrainian woman yevgenia began. she had a rare oncological disease, sarcoma, and the doctors suggested a young girl has a complete amputation of her leg, but she is lucky because her case was taken up by our guest doctor-orthopedic-traumatologist-oncologist oleksandr galuzynsky, we will learn about the girl's story just now, because evgenia is with us now in communication a mrs. yevheniya good afternoon. i greet you, mrs. yevheniya. i would like to hear exactly your story, and we have before and after photos, which we will ask our directors to put on the screen . yes, i lived

a life of course, i went to work, i played sports. if everything was okay, but , you know, small pains began to appear in my leg, well, it happens when something pinches my back, or there i don't know there pulled on for example, she began to smear something there, well , she treated herself there, but if the pain was constantly growing, well, it grew little by little and already there in three months. i even injected morphine and it didn't help. that is, there is no pain for 30 minutes, and then it grows more and grows, and uh, i uh, all this

time, until this pain appeared, i was constantly going there. i tried to get a diagnosis from different doctors, but there they prescribed me either massages or there are ointments, well, if it wasn’t so serious, yes, and uh, already when i was referred to oncologists, because all the tests were normal, and everyone is already throwing up their hands and saying that something is strange, yes, uh, we already did the first brc, because there was some on um, on the x-ray, there were some small spots in the bone, and after that, the biopsy showed that if it wasn't for oncology, everyone would have blushed so much except for me, because if i had it, i would still have pain already for this in the two months when i was there i continued to go about my business after the first biopsy

huge growth in two months there, my entire femur was already affected and only the knee and hip joints were not affected. we began to invent . was it possible to order an implant for me in any country in any country, which er, which they do if well, how do you say that, which they do for everyone yes for all patients a-a therefore, either amputation or some such temporary solution for a year eh well, if we don't have it a young woman arranged amputations. i was 30 years old at the time and had a complete amputation almost to the buttock. well, if it was, well, it was very

scary news for me, so my doctor and i began to think about what we could do. my doctor is a surgeon, an oncologist, a doctor . he is black, he turned to the 3d printing laboratory, and there, together with doctors and engineers, they were able to make me such an individual project that helped me save my leg, and now i walk almost like, well, you can’t say how before the disease, yes, sometimes i i can go around the house to move without a cane and yes, if i go somewhere for a walk because i have to go somewhere on business, i walk with a crutch, but i walk on my own two legs and i am very happy that everything turned out this way ms. evgenia how long did the operation last and how long was your recovery after the operation it lasted for more than 6 hours,

of which i was conscious for about 4 hours, or i had to control this process, too, as a patient, recovery took about six months, i walked on crutches, and even then i gradually bought myself, well, i walked with one crutch later i already switched to a cane here for almost a year. i think i was recovering. thank you, evgenia. thank you for telling your story. i want to ask ms. svitlana. i have a team and we fully check all projects and do them together.