Poppas D P, Massicotte J M, Stewart R B, Roberts A B, Atala A, Retik A B, Freeman M R
Department of Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Lasers Surg Med. 1996;19(3):360-8. doi: 10.1002/(SICI)1096-9101(1996)19:3<360::AID-LSM13>3.0.CO;2-8.
We examined the possibility that human albumin solder can be used as a vehicle for site specific delivery of growth factors for the purpose of accelerating tissue repair following laser welded wound closure. Certain human recombinant growth factors have been shown to accelerate wound healing in model systems. Pilot in vitro studies have established that several growth factors, including TGF-beta 1, maintain bioactivity following exposure to temperatures achieved during laser tissue welding. Using a temperature controlled laser delivery system (TCL) to precisely maintain welding temperatures, it is now possible to avoid thermal denaturation of exogenous bioactive molecules such as growth factors.
STUDY DESIGN/MATERIALS AND METHODS: HB-EGF, bFGF, and TGF-beta 1 were tested in vitro for maintenance of bioactivity after exposure to 80 degrees C. In vivo experiments using porcine skin determined the efficacy of solders augmented with growth factors. Incisions were repaired using human albumin alone or supplemented with HB-EGF (2 micrograms), bFGF (10 micrograms), or TGF-beta 1 (1 microgram). Wounds were excised at 3, 5, and 7 days post-operatively. Tensile strength, total collagen content, and histology were performed.
At 3 days, tensile strength (TS) of TGF-beta 1 wounds were 36% (P < 0.05) and 20% (n.s.) stronger than laser alone and suture closures, respectively. By 5 days the TS of the TGF-beta 1 group increased by 50% (P < 0.05) and 59% (P < 0.02) over laser alone and suture groups, respectively. At 7 days the TGF-beta 1 group was 50% (P < 0.05) and 79% (P < 0.01) stronger than laser solder alone or suture, respectively. The HB-EGF and bFGF groups were equivalent to the laser solder group at all time points. Total collagen TGF-beta 1 Accelerates Healing Following Laser Welding content at 7 days increased in the TGF-beta 1 group by 7% (n.s.) over the suture group and 21% (P < 0.05) in the laser group.
Human albumin solder supplemented with TGF-beta 1 increases the early post-operative strength of laser welded wounds. This novel application of laser tissue soldering augmented with a growth factor has the potential to bring about immediate fluid tight seals while providing site specific delivery of biological modifiers. This may lead to an overall improvement in post-operative convalescence, wound infections, and hospital costs.
我们研究了人白蛋白焊料能否作为生长因子的位点特异性递送载体，用于在激光焊接伤口闭合后加速组织修复。某些人重组生长因子已在模型系统中显示可加速伤口愈合。前期体外研究已证实，包括转化生长因子β1（TGF-β1）在内的几种生长因子在暴露于激光组织焊接过程中所达到的温度后仍能保持生物活性。使用温度控制激光递送系统（TCL）精确维持焊接温度，现在有可能避免外源性生物活性分子如生长因子发生热变性。
研究设计/材料与方法：对肝素结合表皮生长因子（HB-EGF）、碱性成纤维细胞生长因子（bFGF）和TGF-β1在体外暴露于80摄氏度后维持生物活性的情况进行了测试。使用猪皮肤进行的体内实验确定了添加生长因子的焊料的功效。切口分别用人白蛋白单独修复或补充HB-EGF（2微克）、bFGF（10微克）或TGF-β1（1微克）进行修复。在术后3天、5天和7天切除伤口组织。进行了拉伸强度、总胶原蛋白含量和组织学检测。
术后3天，TGF-β1组伤口的拉伸强度分别比单纯激光焊接组和缝合组高36%（P<0.05）和20%（无统计学差异）。到术后5天，TGF-β1组的拉伸强度分别比单纯激光焊接组和缝合组提高了50%（P<0.05）和59%（P<0.02）。术后7天，TGF-β1组分别比单纯激光焊料组和缝合组强50%（P<0.05）和79%（P<0.01）。HB-EGF组和bFGF组在所有时间点均与激光焊料组相当。术后7天，TGF-β1组的总胶原蛋白含量比缝合组增加了7%（无统计学差异），比激光组增加了21%（P<0.05）。
补充TGF-β1的人白蛋白焊料可提高激光焊接伤口术后早期的强度。这种添加生长因子的激光组织焊接新应用有可能实现即时液密密封，同时提供生物修饰剂的位点特异性递送。这可能会使术后康复、伤口感染和医院成本得到全面改善。
