A study on in vitro degradation behavior of a poly(glycolide-co-L-lactide) monofilament

Evaluating Pull-Out Strength of Barbed Suture In Vitro by Using Porcine Tissue and Polydimethylsiloxane (PDMS)

Using barbed thread lifting for facial rejuvenation has become popular these days due to its minimally invasive procedures with reduced complications. However, only limited studies regarding its mechanical properties for face suspension were published. The aim of this study was to evaluate suture-holding ability regarding its facelift property, and different specimens were tested in order to establish an in vitro model. Fresh porcine tissue and the synthetic material polydimethylsiloxane (PDMS) were selected to simulate human skin for evaluating barbed suture pull-out strength by the universal material testing machine. The results showed that the pull-out strength of barbs between different porcine tissues varied without consistency. By contrast, PDMS (30:1) showed more consistent pull-out strength in each testing, and the average maximum load force was close to porcine tissue. Furthermore, after submerging barbed sutures in PBS for 0 days (T0), 7 days (T7) and 14 days (T14), a trend of decreased average maximum load force, displacement and force of 1.5 mm/2 mm/3 mm displacement could be detected by in vitro testing with PDMS (30:1). These results provide support for using PDMS (30:1) to evaluate suture pull-out strength and holding/lifting capacities in vitro to obtain consistent and objective information for evaluating substantial equivalence of devices. The established in vitro method could be used for the future development of barbed thread lifting technology.

The differences between surface degradation and bulk degradation of FEM on the prediction of the degradation time for poly (lactic-co-glycolic acid) stent

The degradation time is a crucial factor in evaluating the performance of poly (lactic-co-glycolic acid) (PLGA) stents. Bulk degradation mode was commonly used to analyze the stent degradation behavior by finite element approach. However, the PLGA stents may present surface degradation more than bulk degradation under certain conditions, which will greatly affect the degradation time after implantation. In this study, the degradation processes of the poly (lactic-co-glycolic acid) stent were reproduced utilizing finite element analysis. Both bulk degradation and surface degradation modes were considered. The correlation between tensile stress and degradation rate was investigated. The degradation time was analyzed selectively. The stress distribution, fracture, and mass loss were also compared between bulk degradation mode and surface degradation mode. The simulation results showed that, in both evolution modes, the degradation began at the 'peak-valley' region and fracture occurred at the cross of links and rings. Additionally, high levels of Von-Mises stress were observed in these two regions. Compared with bulk degradation, the fracture time of the stent was delayed by 63% in the surface degradation mode. In conclusion, the mass loss rate and scaffolding period showed great differences between surface degradation and bulk degradation. Based on this study, it is suggested that bulk degradation mode is not applicable to the case of inadequate water uptake mode, such as the tracheal stent degradation process. More experimental research should be carried out to accurately predict the scaffolding period after implantation. The mechanical properties of the fracture zone should be strengthened.

Natural-Based Biomaterials for Peripheral Nerve Injury Repair

Peripheral nerve injury treatment is a relevant problem because of nerve lesion high incidence and because of unsatisfactory regeneration after severe injuries, thus resulting in a reduced patient's life quality. To repair severe nerve injuries characterized by substance loss and to improve the regeneration outcome at both motor and sensory level, different strategies have been investigated. Although autograft remains the gold standard technique, a growing number of research articles concerning nerve conduit use has been reported in the last years. Nerve conduits aim to overcome autograft disadvantages, but they must satisfy some requirements to be suitable for nerve repair. A universal ideal conduit does not exist, since conduit properties have to be evaluated case by case; nevertheless, because of their high biocompatibility and biodegradability, natural-based biomaterials have great potentiality to be used to produce nerve guides. Although they share many characteristics with synthetic biomaterials, natural-based biomaterials should also be preferable because of their extraction sources; indeed, these biomaterials are obtained from different renewable sources or food waste, thus reducing environmental impact and enhancing sustainability in comparison to synthetic ones. This review reports the strengths and weaknesses of natural-based biomaterials used for manufacturing peripheral nerve conduits, analyzing the interactions between natural-based biomaterials and biological environment. Particular attention was paid to the description of the preclinical outcome of nerve regeneration in injury repaired with the different natural-based conduits.

Comparison of the degradation behavior of PLGA scaffolds in micro-channel, shaking, and static conditions

Degradation of scaffolds is an important problem in tissue regeneration management. This paper reports a comparative study on degradation of the printed 3D poly (lactic-co-glycolic acid) scaffold under three conditions, namely, micro-channel, incubator static, and incubator shaking in the phosphate buffer saline (PBS) solution. In the case of the micro-channel condition, the solution was circulated. The following attributes of the scaffold and the solution were measured, including the mass or weight loss, water uptake, morphological and structural changes, and porosity change of the scaffold and the pH value of the PBS solution. In addition, shear stress in the scaffold under the micro-channel condition at the initial time was calculated with Computational Fluid Dynamics (CFD) to see how the shear stress factor may affect the morphological change of the scaffold. The results showed that the aforementioned attributes in the condition of the micro-channel were significantly different from the other two conditions. The mechanisms that account for the results were proposed. The reasons behind the results were explored. The main contributions of the study were (1) new observations of the degradation behavior of the scaffold under the micro-channel condition compared with the conditions of incubator static and incubator shaking along with underlying reasons, (2) new understanding of the role of the shear stress in the scaffold under the condition of the micro-channel to the morphological change of the scaffold, and (3) new understanding of interactions among the attributes pertinent to scaffold degradation, such as weight loss, water uptake, pH value, porosity change, and morphological change. This study sheds important light on the scaffold degradation to be controlled more precisely.

Biomimetic Architectures for Peripheral Nerve Repair: A Review of Biofabrication Strategies

Biofabrication techniques have endeavored to improve the regeneration of the peripheral nervous system (PNS), but nothing has surpassed the performance of current clinical practices. However, these current approaches have intrinsic limitations that compromise patient care. The "gold standard" autograft provides the best outcomes but requires suitable donor material, while implantable hollow nerve guide conduits (NGCs) can only repair small nerve defects. This review places emphasis on approaches that create structural cues within a hollow NGC lumen in order to match or exceed the regenerative performance of the autograft. An overview of the PNS and nerve regeneration is provided. This is followed by an assessment of reported devices, divided into three major categories: isotropic hydrogel fillers, acting as unstructured interluminal support for regenerating nerves; fibrous interluminal fillers, presenting neurites with topographical guidance within the lumen; and patterned interluminal scaffolds, providing 3D support for nerve growth via structures that mimic native PNS tissue. Also presented is a critical framework to evaluate the impact of reported outcomes. While a universal and versatile nerve repair strategy remains elusive, outlined here is a roadmap of past, present, and emerging fabrication techniques to inform and motivate new developments in the field of peripheral nerve regeneration.

The effect of mechanical loads on the degradation of aliphatic biodegradable polyesters

Aliphatic biodegradable polyesters have been the most widely used synthetic polymers for developing biodegradable devices as alternatives for the currently used permanent medical devices. The performances during biodegradation process play crucial roles for final realization of their functions. Because physiological and biochemical environment in vivo significantly affects biodegradation process, large numbers of studies on effects of mechanical loads on the degradation of aliphatic biodegradable polyesters have been launched during last decades. In this review article, we discussed the mechanism of biodegradation and several different mechanical loads that have been reported to affect the biodegradation process. Other physiological and biochemical factors related to mechanical loads were also discussed. The mechanical load could change the conformational strain energy and morphology to weaken the stability of the polymer. Besides, the load and pattern could accelerate the loss of intrinsic mechanical properties of polymers. This indicated that investigations into effects of mechanical loads on the degradation should be indispensable. More combination condition of mechanical loads and multiple factors should be considered in order to keep the degradation rate controllable and evaluate the degradation process in vivo accurately. Only then can the degradable devise achieve the desired effects and further expand the special applications of aliphatic biodegradable polyesters.

Effects of different fluid shear stress patterns on the in vitro degradation of poly(lactide-co-glycolide) acid membranes

The applications of poly (lactide-co-glycolide) acid (PLGA) for coating or fabricating polymeric biodegradable stents (BDSs) have drawn more attention. The fluid shear stress has been proved to affect the in vitro degradation process of PLGA membranes. During the maintenance, BDSs could be suffered different patterns of fluid shear stress, but the effect of these different patterns on the whole degradation process is unclear. In this study, in vitro degradation of PLGA membranes was examined with steady, sinusoid, and squarewave fluid shear stress patterns in 150 mL deionized water at 37°C for 20 days, emphasizing on the changes in the viscosity of the degradation solution, mechanical, and morphological properties of the samples. The unsteady fluid shear stress with the same average magnitude as the steady one accelerate the in vitro degradation process of PLGA membranes in terms of maximum fluid shear stress and "window" of effectiveness. Maximum fluid shear stress accelerates the in vitro degradation of molecular fragments that diffused out in the solution while the "window" of effectiveness affects too in the early stage. Besides, maximum fluid shear stress and "window" of effectiveness accelerates the in vitro loss of tensile modulus and ultimate strength of the PLGA membranes while the maximum fluid shear stress plays the leading role in the decrease of tensile modulus at the early degradation stage. This study could help advance the degradation design of PLGA membranes under different fluid shear stress patterns for biomedical applications like stents and drug release systems. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 23-30, 2017.

Knot integrity as a function of suture expiration

OBJECTIVE

To test the integrity of knots tied with expired suture and non-expired suture, using 5 different suture materials.

STUDY DESIGN

Knots were tied using expired and non-expired chromic catgut, polyglactin 910, polydioxanone, silk, or coated polyester. Expired sutures were a mean of 10.5 years past the date of expiration stamped on the packaging. Suture packaging was inspected for any flaws or humidity. There were 116 knots with expired suture and 109 non-expired knots. All knots were tied by hand. Suture was soaked in 0.9% sodium chloride for 60 seconds and subsequently transferred to a tensiometer where the tails of the knots were cut to 3 mm length. We compared the tensile strength of knots using a tensiometer to pull the knots until the suture broke or untied. A minimum of 30 knots were needed in order to detect a statistically significant main effect for expired and non-expired sutures with 80% power and a 5% chance of type I error.

RESULTS

A total of 225 knots were tied. Overall, we found no difference in mean tension between expired suture (77.5 ± 31.7 N) and non-expired suture at failure (81.9 ± 30.2 N). All the sutures broke at the knot and none untied. Expired chromic and polydioxanone were significantly weaker than the non-expired suture of the same material (p = 0.002 and p = 0.001, respectively). There was no statistically significant difference in tensile strength between expired absorbable or permanent suture materials. Based on a univariate analysis of variance ([SCAP]ANOVA)[R] there was no difference in the tension at failure between expired and non-expired sutures with suture packet as a covariate. No suture untied when knotted with expired suture.

CONCLUSIONS

Under laboratory conditions, expired chromic and polydioxanone sutures broke at lower tensile strength than non-expired sutures of the same material.

Construction of tissue engineered nerve grafts and their application in peripheral nerve regeneration

Surgical repair of severe peripheral nerve injuries represents not only a pressing medical need, but also a great clinical challenge. Autologous nerve grafting remains a golden standard for bridging an extended gap in transected nerves. The formidable limitations related to this approach, however, have evoked the development of tissue engineered nerve grafts as a promising alternative to autologous nerve grafts. A tissue engineered nerve graft is typically constructed through a combination of a neural scaffold and a variety of cellular and molecular components. The initial and basic structure of the neural scaffold that serves to provide mechanical guidance and optimal environment for nerve regeneration was a single hollow nerve guidance conduit. Later there have been several improvements to the basic structure, especially introduction of physical fillers into the lumen of a hollow nerve guidance conduit. Up to now, a diverse array of biomaterials, either of natural or of synthetic origin, together with well-defined fabrication techniques, has been employed to prepare neural scaffolds with different structures and properties. Meanwhile different types of support cells and/or growth factors have been incorporated into the neural scaffold, producing unique biochemical effects on nerve regeneration and function restoration. This review attempts to summarize different nerve grafts used for peripheral nerve repair, to highlight various basic components of tissue engineered nerve grafts in terms of their structures, features, and nerve regeneration-promoting actions, and finally to discuss current clinical applications and future perspectives of tissue engineered nerve grafts.

Review Paper: Absorbable Polymeric Surgical Sutures: Chemistry, Production, Properties, Biodegradability, and Performance

Among biomaterials used as implants in human body, sutures constitute the largest groups of materials having a huge market exceeding $1.3 billion annually. Sutures are the most widely used materials in wound closure and have been in use for many centuries. With the development of the synthetic absorbable polymer, poly(glycolic acid) (PGA) in the early 1970s, a new chapter has opened on absorbable polymeric sutures that got unprecedented commercial successes. Although several comparative evaluations of suture materials have been published, there were no serious attempts of late on a comprehensive review of production, properties, biodegradability, and performance of suture materials. This review proposes to bring to focus scattered data on chemistry, properties, biodegradability, and performance of absorbable polymeric sutures.

Extracellular matrix expression of human tenocytes in three-dimensional air-liquid and PLGA cultures compared with tendon tissue: implications for tendon tissue engineering

Tenocyte transplantation may prove to be an approach to support healing of tendon defects. Cell-cell and cell-matrix contacts within three-dimensional (3D) cultures may prevent tenocyte dedifferentiation observed in monolayer (2D) culture. The present study compares both neotissue formation and tenocyte extracellular matrix (ECM) expression in 2D and 3D cultures directly with that of native tendon, in order to determine optimal conditions for tendon tissue engineering. Primary human tenocytes were embedded in poly[lactic-co-glycolic-acid] (PLGA)-scaffolds and high-density cultures. Neotissue formation was examined by hematoxyline-eosine (H&E) and immunofluorescence staining. Gene expression of ECM proteins and vascular endothelial growth factor (VEGF) was compared at days 0 (2D), 14, and 28 in 3D cultures and tendon. Histomorphology of 3D culture showed tendon-like tissue as tenocyte cell nuclei became more elongated and ECM accumulated. Type I collagen gene expression was higher in 2D culture than in tendon and decreased in 4-week-old 3D cultures, whereas type III collagen was only elevated in high-density culture compared with tendon. Decorin and COMP were reduced in 2D and increased in 3D culture almost to ex vivo level. These results suggest that the 3D high-density or biodegradable scaffolds cultures encourage the differentiation of expanded monolayer tenocytes in vitro to tendon-like tissue.

Release of PLGA-encapsulated dexamethasone from microsphere loaded porous surfaces

The aim of the present study was to investigate the morphology and function of a drug eluting metallic porous surface produced by the immobilization of poly lactide-co-glycolide microspheres bearing dexamethasone onto plasma electrolytically oxidized Ti-6Al-7Nb medical alloy. Spheres of 20 microm diameter were produced by an oil-in-water emulsion/solvent evaporation method and thermally immobilized onto titanium discs. The scanning electron microscopy investigations revealed that the size distribution and morphology of the attached spheres had not changed significantly. The drug release profiles following degradation in phosphate buffered saline for 1000 h showed that, upon immobilisation, the spheres maintained a sustained release, with a triphasic profile similar to the non-attached system. The only significant change was an increased release rate during the first 100 h. This difference was attributed to the effect of thermal attachment of the spheres to the surface.