Anton-Sales Irene, Roig-Sanchez Soledad, Traeger Kamelia, Weis Christine, Laromaine Anna, Turon Pau, Roig Anna
Institute of Materials Science of Barcelona (ICMAB-CSIC), Campus UAB, 08193 Bellaterra, Catalonia, Spain.
Department of Research and Development, B. Braun Surgical, S.A.U., Carretera de Terrassa 121, Rubí, 08191 Barcelona, Spain.
Biomater Sci. 2021 Apr 21;9(8):3040-3050. doi: 10.1039/d1bm00025j. Epub 2021 Mar 5.
The use of surgical meshes to reinforce damaged internal soft tissues has been instrumental for successful hernia surgery; a highly prevalent condition affecting yearly more than 20 million patients worldwide. Intraperitoneal adhesions between meshes and viscera are one of the most threatening complications, often implying reoperation or side effects such as chronic pain and bowel perforation. Despite recent advances in the optimization of mesh porous structure, incorporation of anti-adherent coatings or new approaches in the mesh fixation systems, clinicians and manufacturers are still pursuing an optimal material to improve the clinical outcomes at a cost-effective ratio. Here, bacterial nanocellulose (BNC), a bio-based polymer, is evaluated as a soft tissue reinforcement material regarding mechanical properties and in vivo anti-adhesive performance. A double-layer BNC laminate proved sufficient to meet the standards of mechanical resistance for abdominal hernia reinforcement meshes. BNC-polypropylene (BNC-PP) composites incorporating a commercial mesh have also been prepared. The in vivo study of implanted BNC patches in a rabbit model demonstrated excellent anti-adherent characteristics of this natural nanofibrous polymer 21-days after implantation and the animals were asymptomatic after the surgery. BNC emerges as a novel and versatile hernioplasty biomaterial with outstanding mechanical and anti-adherent characteristics.
使用外科补片来加强受损的内部软组织对成功进行疝气手术至关重要；疝气是一种高度普遍的病症，全球每年有超过2000万患者受其影响。补片与内脏之间的腹膜粘连是最具威胁性的并发症之一，常常意味着需要再次手术或出现诸如慢性疼痛和肠穿孔等副作用。尽管最近在优化补片多孔结构、添加抗粘连涂层或在补片固定系统方面采用新方法等方面取得了进展，但临床医生和制造商仍在寻求一种性价比高的最佳材料来改善临床效果。在此，对一种基于生物的聚合物——细菌纳米纤维素（BNC）作为软组织增强材料的力学性能和体内抗粘连性能进行了评估。双层BNC层压板被证明足以满足腹部疝气加强补片的机械抗性标准。还制备了包含商用补片的BNC-聚丙烯（BNC-PP）复合材料。在兔模型中对植入的BNC补片进行的体内研究表明，这种天然纳米纤维聚合物在植入21天后具有出色的抗粘连特性，并且动物在手术后没有出现症状。BNC作为一种具有出色机械和抗粘连特性的新型多功能疝修补生物材料而出现。
