Shimada Ryo, Konishi Hayato, Ozawa Hideki, Katsumata Takahiro, Tanaka Ryou, Nakazawa Yasumoto, Nemoto Shintaro
Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
Department of Surgery and Veterinary Medicine, Tokyo University of Agriculture and Technology, Koganei, Japan.
Surg Today. 2018 May;48(5):486-494. doi: 10.1007/s00595-017-1615-6. Epub 2017 Dec 18.
The surgical sheets that are currently used for congenital cardiovascular surgery have several drawbacks, including material deterioration, calcification, and pseudo-intimal proliferation resulting in hemodynamic disturbance. The aim of this study was to evaluate a newly developed sheet made from a combination of silk fibroin (SF) and a synthetic polymer, thermoplastic polyurethane (TPU), for surgical use.
The hybrid SF/TPU sheet was a non-woven fabric with nanofibers that was made using the electrospinning method. The mechanical properties of the SF/TPU sheet were characterized. To determine its biocompatibility, part of the wall of the canine descending aorta was replaced with a SF/TPU sheet as a patch. The patches were removed after 3 months and a histological examination was performed.
The flexibility, water permeability, and suture retention strength of the SF/TPU sheet were excellent and equivalent to those of existing sheets. The SF/TPU sheet had excellent handling properties and fit well into the vascular wall without needle hole bleeding. The histological examination revealed that the intimal tissue was restored well over the intraluminal surface of the explanted SF/TPU sheet, the absence of calcium deposition, and minimal inflammatory reaction, without signs of degradation.
The SF/TPU sheet had excellent mechanical properties and tissue biocompatibility. These favorable features and possible biodegradability of the SF portion warrant a long-term follow-up study.
目前用于先天性心血管手术的手术补片存在几个缺点，包括材料变质、钙化以及导致血流动力学紊乱的假性内膜增生。本研究的目的是评估一种新开发的由丝素蛋白（SF）和合成聚合物热塑性聚氨酯（TPU）组合制成的用于手术的补片。
SF/TPU混合补片是一种采用静电纺丝法制成的具有纳米纤维的无纺布。对SF/TPU补片的力学性能进行了表征。为确定其生物相容性，将犬降主动脉壁的一部分用SF/TPU补片作为贴片进行替换。3个月后取出贴片并进行组织学检查。
SF/TPU补片的柔韧性、透水性和缝线保留强度极佳，与现有补片相当。SF/TPU补片具有出色的操作性能，能很好地贴合血管壁且无针孔出血。组织学检查显示，在取出的SF/TPU补片管腔内表面内膜组织恢复良好，无钙沉积，炎症反应轻微，且无降解迹象。
SF/TPU补片具有出色的力学性能和组织生物相容性。这些良好特性以及SF部分可能的生物可降解性值得进行长期随访研究。
