Department of Surgery, Regional Hospital Liberec a.s., Liberec, Czechia.
Department of Chemistry, Technical University of Liberec, Liberec, Czechia.
Eur Surg Res. 2023;64(4):376-389. doi: 10.1159/000534333. Epub 2023 Oct 25.
The aim of this work was the evaluation of surface modification in surgery of normally used hernia implants and thus improving their antimicrobial properties. The modification consisted of applying hybrid nanolayers with immobilized antiseptic substances (metal cations of Ag, Cu, and Zn) by sol-gel method which ensures prolonged effect of these substances and thus enables a greater resistance of the implant towards infection. In this work, attention is drawn to the issue of applying hybrid nanolayers, activation of mesh surfaces by physical plasma modification or ultraviolet C (UV C) radiation, and influence of these modifications on the mechanical properties of the final meshes. Next work will continue concentrating on the issue of antimicrobial efficacy and eventual toxicity of the prepared layers.
Present-day materials of the most commonly used types of implants for reconstruction of the abdominal wall in surgery (polypropylene, polyester, polyvinylidenefluoride) were tested. Optimum conditions of application of nanolayers by sol-gel method and their thermal stabilization were examined first. Surface modification was verified by scanning electron microscope. The surface of implants was first activated for better adhesion by plasma treatment or UV radiation after preliminary tests. Maximum strength and ductility after activation and hybrid nanolayer modification were objectively measured on a universal Testometric tensile testing machine.
The results of surface activation of the meshes (by both plasma treatment or UV C radiation) provided similar and satisfactory results, and particular conditions differed based on the type of material of the mesh. Usage of antimicrobial sol AD30 diluted by isopropyl alcohol in 1:1 proportion appear to be optimal. All tested cases of meshes activated by plasma treatment or UV C radiation and with applied nanolayer concluded in a slight reduction of mechanical properties in modified meshes in comparison with the original ones. However, a slight reduction of test values was not of clinical importance.
It was verified that surface modification of implants by sol-gel method is effective and technically possible, providing hopeful results.
本工作的目的是评估在常用疝修补植入物手术中的表面改性，从而提高其抗菌性能。改性方法是通过溶胶-凝胶法施加固定有抗菌物质（Ag、Cu 和 Zn 的金属阳离子）的混合纳米层，这确保了这些物质的长效作用，从而使植入物具有更大的抗感染能力。在这项工作中，我们关注的是施加混合纳米层、通过物理等离子体改性或紫外线 C（UV C）辐射激活网孔表面，以及这些改性对最终网孔机械性能的影响。下一步的工作将继续集中研究抗菌功效和所制备层的潜在毒性问题。
测试了当前在手术中用于重建腹壁的最常用类型植入物（聚丙烯、聚酯、聚偏二氟乙烯）的材料。首先检查了通过溶胶-凝胶法施加纳米层的最佳条件及其热稳定化。通过扫描电子显微镜验证表面改性。在等离子体处理或紫外线辐射之前进行初步测试后，对植入物的表面进行了激活以改善其附着力。在万能试验机上对等离子体处理或 UV C 辐射激活和混合纳米层改性后的最大强度和延展性进行了客观测量。
网孔表面激活（通过等离子体处理或 UV C 辐射）的结果相似且令人满意，具体条件因网孔材料的类型而异。使用稀释 1:1 的异丙醇的抗菌溶胶 AD30 似乎是最佳的。通过等离子体处理或 UV C 辐射激活并施加纳米层的所有测试网孔都导致改性网孔的机械性能略有降低，与原始网孔相比。然而，测试值的轻微降低在临床上并不重要。
通过溶胶-凝胶法对植入物进行表面改性是有效且技术上可行的，结果有希望。
