Division of Engineering in Medicine, Department of Medicine, Biomaterials Innovation Research Center, Brigham & Women's Hospital, Harvard Medical School, Cambridge, MA, 02139, USA.
Division of Health Sciences & Technology, Harvard-Massachusetts Institute of Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
Macromol Biosci. 2017 Dec;17(12). doi: 10.1002/mabi.201700304. Epub 2017 Nov 16.
Sutures are one of the most widely used devices for adhering separated tissues after injury or surgery. However, most sutures require knotting, which can create a risk of inflammation, and can act as mechanically weak points that often result in breakage and slipping. Here, an anchoring suture is presented with a design that facilitates its propagation parallel to the suturing direction, while maximizing its resistive force against the opposite direction of external force to lock its position in tissues. Different microstructures of suture anchors are systematically designed using orthogonal arrays, and selected based on shape factors associated with mechanical strength. 3D printing is used to fabricate different types of hollow microstructured suture anchors, and optimize their structure for the effective shaping of tissues. To define the structural design for fixing tissues, the maximum force required to pull 3D printed anchors in different directions is examined with tissues. The tissue reshaping function of suture anchors is further simulated ex vivo by using swine ear, nose, and skin, and bovine muscle tendon. This study provides advantages for building functional sutures that can be used for permanently reshaping tissues with enhanced mechanical strength, eliminating the need for knotting to improve surgical efficiency.
缝线是用于在受伤或手术后将分离的组织黏合在一起的最广泛使用的器械之一。然而,大多数缝线需要打结,这可能会导致炎症风险,并作为机械上的弱点,经常导致断裂和滑脱。在这里,提出了一种锚固缝线,其设计便于其沿缝合方向传播,同时最大限度地提高其抵抗外力相反方向的阻力,以锁定其在组织中的位置。使用正交数组系统地设计了不同的缝线锚的微结构,并根据与机械强度相关的形状因素进行选择。使用 3D 打印技术制造不同类型的中空微结构缝线锚,并优化其结构以有效塑造组织。为了定义用于固定组织的结构设计,用组织检查了在不同方向拉动 3D 打印锚所需的最大力。通过使用猪耳、鼻和皮肤以及牛肌肉肌腱,进一步在体外模拟缝线锚的组织重塑功能。这项研究为构建功能缝线提供了优势,这些缝线可用于永久性重塑组织,增强机械强度,无需打结以提高手术效率。