Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands; Amsterdam Reproduction and Development research institute, Amsterdam, the Netherlands.
Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location AMC, Amsterdam, the Netherlands; Amsterdam Reproduction and Development research institute, Amsterdam, the Netherlands.
J Mech Behav Biomed Mater. 2023 Mar;139:105680. doi: 10.1016/j.jmbbm.2023.105680. Epub 2023 Jan 13.
Amniotic membranes (AM) have shown its great potential in reconstructive surgery due to their regenerative capacity. However, AM is regarded to be relatively weak when applied for load-bearing purposes. This study aims to produce an AM-based scaffold that can withstand the mechanical loads applied in vesicovaginal fistula repair. Different strategies are investigated to improve the mechanical characteristics of AM.
Single and multilayered AM, and composite constructs of AM with electrospun poly-4-hydroxybutyrate (P4HB) or bovine pericardial tissue combined with the use of fibrin glue, were mechanically tested in this study. Suture retention strength and mechanical characteristics (tensile stress, elongation, tangent modulus and maximum load) were assessed by uniaxial testing. The effect of degradation of the composite constructs on the mechanical characteristics was determined by uniaxial testing after 4 and 8 weeks.
Single and multilayered AM could not provide the mechanical requirements needed for surgical implantation (>2N load). AM was combined successfully with electrospun P4HB and bovine pericardium with the use of fibrin glue and were able to exceed the 2N load.
The composite constructs with AM showed sufficient mechanical characteristics for surgical implantation. Electrospun P4HB combined with AM seemed the most promising candidate since the mechanical characteristics of P4HB can be further modified to meet the requirements of the application site and the degradation of the P4HB allows a gradual transfer of load. Eventhough the scaffold is intended for fistula repair, it can potentially be applied in surgical reconstruction of other hollow organs by modifying the mechanical characteristics.
由于具有再生能力，羊膜（AM）在重建外科中显示出巨大的潜力。然而，当用于承重目的时，AM 被认为相对较弱。本研究旨在生产一种能够承受在膀胱阴道瘘修复中施加的机械负荷的基于 AM 的支架。研究了不同的策略来改善 AM 的机械特性。
本研究对单层和多层 AM 以及与静电纺丝聚 4-羟基丁酸酯（P4HB）或牛心包组织结合使用纤维蛋白胶的 AM 复合材料进行了机械测试。通过单轴测试评估缝线保持强度和机械特性（拉伸应力、伸长率、切线模量和最大载荷）。通过单轴测试确定复合结构在 4 和 8 周后的降解对机械特性的影响。
单层和多层 AM 无法提供手术植入所需的机械要求（>2N 载荷）。成功地将 AM 与静电纺丝 P4HB 和牛心包结合使用纤维蛋白胶，能够超过 2N 的载荷。
AM 的复合结构具有足够的手术植入机械特性。与 AM 结合的静电纺丝 P4HB 似乎是最有前途的候选物，因为 P4HB 的机械特性可以进一步修改以满足应用部位的要求，并且 P4HB 的降解允许逐渐转移负荷。尽管该支架旨在用于瘘修复，但通过修改机械特性，它有可能应用于其他中空器官的手术重建。
