Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany.
Clinic of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany.
J Biomater Appl. 2024 Mar;38(8):905-914. doi: 10.1177/08853282241233194. Epub 2024 Feb 15.
Complications of transcutaneous osseointegrated prosthetic systems (TOPS) focus on the metal-cutaneous interface at the stoma. Besides pain due to scare tissue as well as undefined neuropathic disorders, there is high evidence that the stoma presents the main risk causing hypergranulation and ascending infection. To restore the cutaneous barrier function in this functional area, soft-tissue on- or in-growth providing a vital and mechanically stable bio-artificial conjunction is considered a promising approach. In this study we assessed viability and proliferation of adult human dermal fibroblasts (HDFa) on modifications of a standard prosthetic titanium surface. Un-coated (TiAl6V4) as well as a titanium-nitrite (TiN) coated additive manufactured porous three-dimensional surface structures (EPORE®) were seeded with HDFa and compared to plain TiAl6V4 and polystyrene surfaces as control. Cell viability and proliferation were assessed at 24 h and 7 days after seeding with a fluorescence-based live-dead assay. Adhesion and cell morphology were analyzed by scanning electron microscopy at the respective measurements. Both EPORE® surface specifications revealed a homogenous cell distribution with flat and spread cell morphology forming filopodia at both measurements. Proliferation and trend to confluence was seen on un-coated EPORE® surfaces with ongoing incubation but appeared substantially lower on the TiN-coated EPORE® specification. While cell viability on both EPORE® specifications was comparable to plain TiAL6V4 and polystyrene controls, cell proliferation and confluence were less pronounced when compared to controls. The EPORE® topography allows for fibroblast adhesion and viability in both standard TiAl6V4 and - to a minor degree - TiN-coated specifications as a proof of principle.
经皮骨整合假体系统（TOPS）的并发症主要集中在造口处的金属-皮肤界面。除了由于疤痕组织引起的疼痛和未明确的神经病变外，有充分证据表明造口是导致过度肉芽形成和上行感染的主要风险因素。为了恢复该功能区域的皮肤屏障功能，人们认为软组织向内或向外生长以提供有生命力且机械稳定的生物人工连接是一种很有前途的方法。在这项研究中，我们评估了成年人类真皮成纤维细胞（HDFa）在标准假体钛表面改性上的生存力和增殖能力。未涂层（TiAl6V4）以及涂有钛氮化物（TiN）的增材制造多孔三维表面结构（EPORE®）都被接种了 HDFa，并与纯 TiAl6V4 和聚苯乙烯表面作为对照进行了比较。在接种后 24 小时和 7 天，使用荧光死活检测法评估细胞活力和增殖。通过扫描电子显微镜在相应的测量时分析粘附和细胞形态。两种 EPORE®表面规格均显示出均匀的细胞分布，细胞形态平坦且扩散，在两种测量中都形成了丝状伪足。在未涂层的 EPORE®表面上，随着孵育的进行，出现了增殖和融合趋势，但在 TiN 涂层的 EPORE®规格上，这种趋势明显较低。虽然两种 EPORE®规格的细胞活力与纯 TiAL6V4 和聚苯乙烯对照物相当，但与对照物相比，细胞增殖和融合程度较低。EPORE®的拓扑结构允许成纤维细胞在标准 TiAl6V4 以及在较小程度上在 TiN 涂层规格上附着和存活，这是一个原理证明。
