Wiegmann Bettina, Korossis Sotirios, Burgwitz Karin, Hurschler Christof, Fischer Stefan, Haverich Axel, Kuehn Christian
Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany; Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Hannover, Germany.
Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Hannover, Germany.
Ann Thorac Surg. 2015 Mar;99(3):991-8. doi: 10.1016/j.athoracsur.2014.09.040. Epub 2015 Jan 10.
Various biological and synthetic materials have been proposed for use in skeletal chest wall reconstruction (SCWR). Because of the lack of studies allowing a direct comparison of SCWR materials, their clinical use often depends on the surgeon's preference and experience. The aim of this study was to analyze 6 synthetic and 3 biological materials frequently used in SCWR with respect to their cytotoxicity, bacterial adhesion, surface characteristics, and mechanical properties to facilitate data-driven decisions.
The effect of the SCWR materials and their extracts on the metabolism of human skeletal muscle cells (SkMCs), dermal fibroblasts, adipose cells, and osteoblasts was analyzed in vitro. Bacterial adhesion was quantified by incubating samples in bacterial suspensions (Staphylococcus epidermidis, S aureus, and Escherichia coli), followed by counting colony-forming units and performing scanning electron microscopy. Moreover, the mechanical properties of the materials were analyzed under uniaxial tensile loading to failure.
The metabolism of all cell types seeded on the SCWR materials was reduced compared with untreated cells. With the exception of Vypro (Ethicon, Somerville, NJ), whose extracts significantly reduced fibroblast viability, no cytotoxic leachable substances were detected. Biological materials were less cytotoxic compared with synthetic ones, but they demonstrated increased bacterial adhesion. Synthetic materials demonstrated higher elongation to failure than did biological materials.
Biological and synthetic SCWR materials showed significant differences in their cytotoxicity, bacterial adhesion, and biomechanical properties, suggesting that they may be used for different indications in SCWR. Further comparable in vivo studies are needed to analyze their performance in different indications of clinical application.
已提出多种生物和合成材料用于胸廓骨骼重建（SCWR）。由于缺乏能直接比较SCWR材料的研究，其临床应用往往取决于外科医生的偏好和经验。本研究的目的是分析6种常用于SCWR的合成材料和3种生物材料的细胞毒性、细菌黏附性、表面特性和力学性能，以促进基于数据的决策。
在体外分析SCWR材料及其提取物对人骨骼肌细胞（SkMCs）、真皮成纤维细胞、脂肪细胞和成骨细胞代谢的影响。通过将样品在细菌悬液（表皮葡萄球菌、金黄色葡萄球菌和大肠杆菌）中孵育，然后计数菌落形成单位并进行扫描电子显微镜检查，对细菌黏附进行定量。此外，在单轴拉伸加载至破坏的情况下分析材料的力学性能。
与未处理的细胞相比，接种在SCWR材料上的所有细胞类型的代谢均降低。除了Vypro（Ethicon，萨默维尔，新泽西州），其提取物显著降低了成纤维细胞的活力外，未检测到细胞毒性可浸出物质。与合成材料相比，生物材料的细胞毒性较小，但它们表现出细菌黏附增加。合成材料的断裂伸长率高于生物材料。
生物和合成的SCWR材料在细胞毒性、细菌黏附性和生物力学性能方面存在显著差异，表明它们可能用于SCWR的不同适应症。需要进一步进行可比的体内研究，以分析它们在不同临床应用适应症中的性能。
