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Lu S, Wang P, Wang Q, Deng P, Yuan Y, Fu X, Yang Y, Tan L, Yang K, Qi X. Biodegradable high-nitrogen iron alloy anastomotic staples: In vitro and in vivo studies. Bioact Mater 2024; 40:34-46. [PMID: 38910967 PMCID: PMC11190430 DOI: 10.1016/j.bioactmat.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/26/2024] [Accepted: 06/01/2024] [Indexed: 06/25/2024] Open
Abstract
For gastrointestinal anastomosis, metallic biodegradable staples have a broad application potential. However, both magnesium and zinc alloys have relatively low strength to withstand the repeated peristalsis of the gastrointestinal tract. In this study, we developed a novel kind of biodegradable high-nitrogen iron (HN-Fe) alloy wires (0.23 mm), which were fabricated into the staples. The tensile results showed that the ultimate tensile strength and elongation of HN-Fe wires were 1023.2 MPa and 51.0 %, respectively, which was much higher than those of other biodegradable wires. The degradation rate in vitro of HN-Fe wires was slightly higher than that of pure Fe wires. After 28 days of immersion, the tensile strength of HN-Fe wires remained not less than 240 MPa, meeting the clinical requirements. Furthermore, sixteen rabbits were enrolled to conduct a comparison experiment using HN-Fe and clinical Ti staples for gastroanastomosis. After 6 months of implantation, a homogeneous degradation product layer on HN-Fe staples was observed and no fracture occurred. The degradation rate of HN-Fe staples in vivo was significantly higher than that in vitro, and they were expected to be completely degraded in 2 years. Meanwhile, both benign cutting and closure performance of HN-Fe staples ensured that all the animals did not experience hemorrhage and anastomotic fistula during the observation. The anastomosis site healed without histopathological change, inflammatory reaction and abnormal blood routine and biochemistry, demonstrating good biocompatibility of HN-Fe staples. Thereby, the favorable performance makes the HN-Fe staples developed in this work a promising candidate for gastrointestinal anastomosis.
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Affiliation(s)
- Sihan Lu
- School of Intelligent Medicine, China Medical University, Shenyang, 110122, China
| | - Peng Wang
- Department of Interventional Therapy, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Qingchuan Wang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
| | - Peng Deng
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Yonghui Yuan
- Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Clinical Research Center for Malignant Tumor of Liaoning Province, Shenyang, 110801, China
| | - Xiaoqing Fu
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
| | - Yinghui Yang
- Silvan Medical Device Co., Ltd., Suzhou, 215004, China
| | - Lili Tan
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
| | - Xun Qi
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Hospital of China Medical University, Shenyang, 110001, China
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2
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Zhang Y, Cao J, Lu M, Shao Y, Jiang K, Yang X, Xiong X, Wang S, Chu C, Xue F, Ye Y, Bai J. A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation. Bioact Mater 2022; 22:225-238. [PMID: 36254273 PMCID: PMC9550537 DOI: 10.1016/j.bioactmat.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/03/2022] [Accepted: 09/21/2022] [Indexed: 10/27/2022] Open
Abstract
Staplers have been widely used in the clinical treatment of gastrointestinal reconstruction. However, the current titanium (Ti) staple will remain in the human body permanently, resulting in some adverse effects. In this study, we developed a type of biodegradable staple for colonic anastomosis using 0.3 mm diameter magnesium (Mg) alloy wires. The wire surface was modified by micro-arc oxidation treatment (MAO) and then coated with poly-l-lactic acid (PLLA) to achieve a moderate degradation rate matching the tissue healing process. The results of tensile tests on isolated porcine colon tissue anastomosed by Mg and Ti staples showed that the anastomotic property of Mg staples was almost equal to that of Ti staples. The in vitro degradation tests indicated the dual-layer coating effectively enhanced the corrosion resistance and maintained the tensile force of the coated staple stable after 14-day immersion in the simulated colonic fluid (SCF). Furthermore, 24 beagle dogs were employed to conduct a comparison experiment using Mg-based and clinical Ti staples for 90-day implantation by ent-to-side anastomosis of the colon. The integrated structure of Mg-based staples was observed after 7 days and completely degraded after 90 days. All animals did not have anastomotic leakage and stenosis, and 12 dogs with Mg-based staples fully recovered after 90 days without differences in visceral ion levels and other side effects. The favorable performance makes this Mg-based anastomotic staple an ideal candidate for colon reconstruction.
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Affiliation(s)
- Yue Zhang
- Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China,Institute of Biomedical Devices (Suzhou), Southeast University, Suzhou, 215163, China
| | - Jian Cao
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Mengmeng Lu
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yi Shao
- Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China,Institute of Biomedical Devices (Suzhou), Southeast University, Suzhou, 215163, China
| | - Kewei Jiang
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Xiaodong Yang
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Xiaoyu Xiong
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Shan Wang
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China
| | - Chenglin Chu
- Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China
| | - Feng Xue
- Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China,Institute of Biomedical Devices (Suzhou), Southeast University, Suzhou, 215163, China
| | - Yingjiang Ye
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, 100044, China,Corresponding author.
| | - Jing Bai
- Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China,Institute of Biomedical Devices (Suzhou), Southeast University, Suzhou, 215163, China,Jiangsu Key Laboratory for Light Metal Alloys, Nanjing, 211212, China,Corresponding author. Jiangsu Key Laboratory for Advanced Metallic Materials, School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China.
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3
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Wang X, Zhang L, Zhang X, Zhang S, Yan J. Mg-6Zn alloys promote the healing of intestinal anastomosis via TGF-β/Smad signaling pathway in regulation of collagen metabolism as compared with titanium alloys. J Biomater Appl 2022; 36:1540-1549. [PMID: 35114835 DOI: 10.1177/08853282211066555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a great clinical need for biodegradable materials. This study aimed to investigate the effects of Mg-6Zn and titanium alloy stapler nails on intestinal anastomosis healing mediated via the TGF-β/Smad signaling pathway, as reflected in collagen metabolism in rabbits. Side-to-side ileo-ileostomy was performed with linear stapler loaded with the two nails. The results showed that no obvious postoperative complications such as abdominal infection and anastomotic leakage were observed. General observation and scanning electron microscope showed that Mg-6Zn alloy nails remained intact in the first week, degraded significantly in the second week, and were little left in the third week, while the titanium alloy nails showed intact substrate throughout the experimental period. Immunohistochemical analysis showed that the expression of TGF-β1 in Mg-6Zn alloy group was higher than that in titanium alloy group after 1 week, but it increased slowly, arrived at a lower level in the third week. Collagen I showed an increased expression in Mg-6Zn alloy group, but decreased with time in titanium alloy group. An enhanced expression of collagen III in Mg-6Zn alloy group in the first week but much lower in the third week as compared to the titanium alloy group. The expression of smad2 in Mg-6Zn alloy group maintained a steady level, while in titanium alloy group it showed a general upward trend. The expression of smad3 in both groups held steady after 2 weeks, then in the third week, it showed a strong uptrend in Mg-6Zn alloy group, while decreased immediately in titanium alloy group. Our findings suggest that Mg-6Zn alloy nails degraded significantly within 3 weeks and could provide stability of intestinal anastomosis in the reconstruction of intestinal tract. TGF-β/Smad signaling pathway may play a role in regulation of baseline collagen synthesis throughout the process.
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Affiliation(s)
- Xiaohu Wang
- Department of Urology56709, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Luyan Zhang
- Department of Urology56709, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Xiaonong Zhang
- Department of Ophthalmology469915, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Shaoxiang Zhang
- Department of Ophthalmology469915, Taizhou Hospital of Zhejiang Province, Linhai, China
| | - Jun Yan
- Department of General Surgery74659, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University
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Guo H, Hu J, Shen Z, Du D, Zheng Y, Peng J. In vitro and in vivo studies of biodegradable Zn-Li-Mn alloy staples designed for gastrointestinal anastomosis. Acta Biomater 2021; 121:713-723. [PMID: 33321221 DOI: 10.1016/j.actbio.2020.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 01/06/2023]
Abstract
Zn-0.8 wt.% Li-0.1 wt.% Mn wire with the diameter of 0.3 mm was fabricated and further processed into gastrointestinal staple, and its in vitro and in vivo biodegradation behavior and biocompatibility were studied systematically. The experimental Zn-Li-Mn alloy staple could deform from the original U-shape to B-shape without fracture, indicating its good mechanical property. Due to the residual stress concentration caused by anastomosis deformation, the feet and leg arc part of the staple were more prone to degradation. The Zn-Li-Mn alloy staple sustained integrity after immersion in Hanks' solution and simulated gastric fluid (SGF) for 28 days, and the degradation rate in SGF was about 4 times of that in Hanks' solution. Furthermore, Zn-Li-Mn alloy staples were utilized for gastrointestinal anastomosis in pig models, with clinically-used titanium alloy staples as a comparison. No anastomotic leakage and severe inflammation were observed after operation. The Zn-Li-Mn alloy staple maintained mechanical integrity within 8 weeks' implantation. The gastrointestinal tissue healed after 12 weeks, and no obvious side effects were detected during the whole implantation period, demonstrating the good biocompatibility of Zn-Li-Mn alloy staple. Thus, Zn-Li-Mn alloy staple fabricated in this work displayed the promising potential in the gastrointestinal anastomosis.
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5
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Li W, Yuan F, Bai J, Cheng J, Li H, Zheng J, Bai W, Lyu P. In vivo evaluation of bending strengths and degradation rates of different magnesium pin designs for oral stapler. J Appl Biomater Funct Mater 2020; 18:2280800019836400. [PMID: 33372827 DOI: 10.1177/2280800019836400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Magnesium alloys have been potential biodegradable implants in the areas of bone, cardiovascular system, gastrointestinal tract, and so on. The purpose of this study is to evaluate Mg-2Zn alloy degradation as a potential suture material. The study included Sprague-Dawley (SD) rats in vivo. In 24 male SD rats, tests in the leg muscle were conducted using traditional surgical incision and insertion of magnesium alloys of different designs into the tissue. The material degradation topography, elemental composition, and strength of the pins were analyzed. This paper explores magnesium pins with different cross-sectional shapes and diameters to establish a suitable pin diameter and shape for use as an oral stapler, which must have a good balance of degradation rate and strength. The results showed there were good bending strengths over different degradation periods in groups with diameters of 0.8 mm and 0.5 mm, and no significantly different bending strength between the groups of triangle and round cross-section shapes with same diameter of 0.3 mm, although the degradation rate still needs to be improved.
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Affiliation(s)
- Wenjun Li
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, China
| | - Fusong Yuan
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Nanjing, China
| | - Junyao Cheng
- School of Materials Science and Engineering, Southeast University, Nanjing, China
| | - Hongxiang Li
- State Key Laboratory for Advanced Metals and Materials, University of Science and Technology Beijing, China
| | - Jianqiao Zheng
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, China
| | - Wei Bai
- Dental Medical Devices Testing Center, Peking University School of Stomatology, Beijing, China
| | - Peijun Lyu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, China
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Xia J, Chen H, Yan J, Wu H, Wang H, Guo J, Zhang X, Zhang S, Zhao C, Chen Y. High-Purity Magnesium Staples Suppress Inflammatory Response in Rectal Anastomoses. ACS APPLIED MATERIALS & INTERFACES 2017; 9:9506-9515. [PMID: 28240546 DOI: 10.1021/acsami.7b00813] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Magnesium-based materials are promising biodegradable implants, although the impact of magnesium on rectal anastomotic inflammation is poorly understood. Thus, we investigated the inflammatory effects of high-purity Mg staples in rectal anastomoses by in vivo luciferase reporter gene expression in transgenic mice, hematoxylin-eosin staining, immunohistochemistry, and Western blotting. As expected, strong IL-1β-mediated inflammation and inflammatory cell infiltration were observed 1 day after rectal anastomoses were stapled with high-purity Mg or Ti. However, inflammation and inflammatory cell infiltration decreased more robustly 4-7 days postoperation in tissues stapled with high-purity Mg. This rapid reduction in inflammation was confirmed by immunohistochemical analysis of IL-6 and TNF-α. Western blot also suggested that the reduced inflammatory response is due to suppressed TLR4/NF-κB signaling. In contrast, MCP-1, uPAR, and VEGF were abundantly expressed, in line with the notion that expression of these proteins is regulated by feedback between the VEGF and NF-κB pathways. In vitro expression of MCP-1, uPAR, and VEGF was also similarly high in primary rectal mucosal epithelial cells exposed to extracts from Mg staples, as measured by antibody array. Collectively, the results suggest that high-purity Mg staples suppress the inflammatory response during rectal anastomoses via TLR4/NF-κB and VEGF signaling.
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Affiliation(s)
- Jiazeng Xia
- Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China
| | - Hui Chen
- Department of Pathology, Nanjing General Hospital , Jiangsu 210002, People's Republic of China
| | - Jun Yan
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai 200233, People's Republic of China
| | - Hongliu Wu
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China
| | - Hao Wang
- Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China
| | - Jian Guo
- Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China
| | - Xiaonong Zhang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China
| | - Shaoxiang Zhang
- Suzhou Origin Medical Technology Company Ltd. , 2 Haicheng Road, Changshu Economic and Technology Development Zone, Jiangsu 215513, People's Republic of China
| | - Changli Zhao
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University , Shanghai 200240, People's Republic of China
| | - Yigang Chen
- Department of General Surgery, Wuxi Second Hospital, Nanjing Medical University , Jiangsu 214002, People's Republic of China
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7
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Wang XH, Ni JS, Cao NL, Yu S, Chen YG, Zhang SX, Gu BJ, Yan J. In vivo evaluation of Mg-6Zn and titanium alloys on collagen metabolism in the healing of intestinal anastomosis. Sci Rep 2017; 7:44919. [PMID: 28317926 PMCID: PMC5357906 DOI: 10.1038/srep44919] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 02/16/2017] [Indexed: 12/04/2022] Open
Abstract
There is a great clinical need for biodegradable materials, which were used as pins of circular staplers, for gastrointestinal reconstruction in medicine. In this work we compared the effects of the Mg-6Zn and the titanium alloys on collagen metabolism in the healing of the intestinal tract in vivo. The study included Sprague-Dawley rats and their effect was compared on rat's intestinal tract, using serum magnesium, radiology, and immunohistochemistry in vivo. Radiographic and scanning electron microscope evaluation confirmed the degradation by Mg-6Zn alloy during the implantation period. Biochemical measurements including serum magnesium, creatinine, blood urea nitrogen and glutamic-pyruvic-transaminase proved that degradation of Mg-6Zn alloy showed no impact on serum magnesium and the function of other important organs. Superior to titanium alloy, Mg-6Zn alloy enhanced the expression of collagen I/III and relatively suppressed the expression of MMP-1/-13 in the healing tissues, leading to more mature collagen formation at the site of anastomosis. In conclusion, Mg-6Zn alloy performed better than titanium alloy on collagen metabolism and promoted the healing of intestinal anastomosis. Hence, Mg-6Zn may be a promising candidate for use of stapler pins for intestinal reconstruction in the clinically.
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Affiliation(s)
- Xiao-hu Wang
- Department of Urology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jian-shu Ni
- Department of Urology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
| | - Nai-long Cao
- Department of Urology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
| | - Song Yu
- Department of General Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yi-gang Chen
- Department of General Surgery, Nanjing Medical University Affiliated Wuxi No. 2 People’s Hospital, Nanjing 214002, China
| | | | - Bao-jun Gu
- Department of Urology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jun Yan
- Department of General Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
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8
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Mukherjee K, Kavalukas SL, Barbul A. Nutritional Aspects of Gastrointestinal Wound Healing. Adv Wound Care (New Rochelle) 2016; 5:507-515. [PMID: 27867755 DOI: 10.1089/wound.2015.0671] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/23/2015] [Indexed: 02/07/2023] Open
Abstract
Significance: Although the wound healing cascade is similar in many tissues, in the gastrointestinal tract mucosal healing is critical for processes such as inflammatory bowel disease and ulcers and healing of the mucosa, submucosa, and serosal layers is needed for surgical anastomoses and for enterocutaneous fistula. Failure of wound healing can result in complications including infection, prolonged hospitalization, critical illness, organ failure, readmission, new or worsening enterocutaneous fistula, and even death. Recent Advances: Recent advances are relevant for the role of specific micronutrients, such as vitamin D, trace elements, and the interplay between molecules with pro- and antioxidant properties. Our understanding of the role of other small molecules, genes, proteins, and macronutrients is also rapidly changing. Recent work has elucidated relationships between oxidative stress, nutritional supplementation, and glucose metabolism. Thresholds have also been established to define adequate preoperative nutritional status. Critical Issues: Further work is needed to establish standards and definitions for measuring the extent of wound healing, particularly for inflammatory bowel disease and ulcers. In addition, a mounting body of evidence has determined the need for adequate preoperative nutritional supplementation for elective surgical procedures. Future Directions: A large portion of current work is restricted to model systems in rodents. Therefore, additional clinical and translational research is needed in this area to promote gastrointestinal wound healing in humans, particularly those suffering from critical illness, patients with enterocutaneous fistula, inflammatory bowel disease, and ulcers, and those undergoing surgical procedures.
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Affiliation(s)
- Kaushik Mukherjee
- Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sandra L. Kavalukas
- Department of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Adrian Barbul
- Department of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Wu H, Zhao C, Ni J, Zhang S, Liu J, Yan J, Chen Y, Zhang X. Research of a novel biodegradable surgical staple made of high purity magnesium. Bioact Mater 2016; 1:122-126. [PMID: 29744400 PMCID: PMC5883960 DOI: 10.1016/j.bioactmat.2016.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 12/13/2022] Open
Abstract
Surgical staples made of pure titanium and titanium alloys are widely used in gastrointestinal anastomosis. However the Ti staple cannot be absorbed in human body and produce artifacts on computed tomography (CT) and other imaging examination, and cause the risk of incorrect diagnosis. The bioabsorbable staple made from polymers that can degrade in human body environment, is an alternative. In the present study, biodegradable high purity magnesium staples were developed for gastric anastomosis. U-shape staples with two different interior angles, namely original 90° and modified 100°, were designed. Finite element analysis (FEA) showed that the residual stress concentrated on the arc part when the original staple was closed to B-shape, while it concentrated on the feet for the modified staple after closure. The in vitro tests indicated that the arc part of the original staple ruptured firstly after 7 days immersion, whereas the modified one kept intact, demonstrating residual stress greatly affected the corrosion behavior of the HP-Mg staples. The in vivo implantation showed good biocompatibility of the modified Mg staples, without inflammatory reaction 9 weeks post-operation. The Mg staples kept good closure to the Anastomosis, no leaking and bleeding were found, and the staples exhibited no fracture or severe corrosion cracks during the degradation. A modified structure with about 100° interior angle of U-shape was selected by using FEA. In vitro immersion experiment showed homogeneous corrosion behavior of the modified HP-Mg surgical staple. In vivo implantation suggested that the modified HP-Mg surgical staple had enough closure strength and good biocompatibility.
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Affiliation(s)
- Hongliu Wu
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Changli Zhao
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Jiahua Ni
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Shaoxiang Zhang
- Suzhou Origin Medical Technology Co. Ltd., Jiangsu 215513, China
| | - Jingyi Liu
- Suzhou Origin Medical Technology Co. Ltd., Jiangsu 215513, China
| | - Jun Yan
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Yigang Chen
- Department of General Surgery, Wuxi No. 2 People's Hospital, Nanjing Medical University, Wuxi, 214002, China
| | - Xiaonong Zhang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.,Suzhou Origin Medical Technology Co. Ltd., Jiangsu 215513, China
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10
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Fazel Anvari-Yazdi A, Tahermanesh K, Hadavi SMM, Talaei-Khozani T, Razmkhah M, Abed SM, Mohtasebi MS. Cytotoxicity assessment of adipose-derived mesenchymal stem cells on synthesized biodegradable Mg-Zn-Ca alloys. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 69:584-97. [PMID: 27612751 DOI: 10.1016/j.msec.2016.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/13/2016] [Accepted: 07/06/2016] [Indexed: 11/16/2022]
Abstract
Magnesium (Mg)-based alloys have been extensively considered as biodegradable implant materials for orthopedic surgery. Mg and its alloys are metallic biomaterials that can degrade in the body and promote new bone formation. In this study, the corrosion behavior and cytotoxicity of Mg-Zn-Ca alloys are evaluated with adipose-derived mesenchymal stem cells (ASCs). Mg-2Zn and Mg-2Zn-xCa (x=1, 2 and 3wt.%) alloys were designated. Mg alloys were analyzed with scanning electron microscopy and potentiodynamic polarization. To understand the in-vitro biocompatibility and cytotoxicity of Mg-2Zn and Mg-2Zn-xCa alloys, ASCs were cultured for 24 and 72h in contact with 10%, 50% and 100% extraction of all alloys prepared in DMEM. Cell cytotoxicity and viability of ASCs were examined by MTT assay. Alloying elements including Zn and Ca improved the corrosion resistance of alloys were compared with pure Mg. The cytotoxicity results showed that all alloys had no significant adverse effects on cell viability in 24h. After 72h, cell viability and proliferation increased in the cells exposed to pure Mg and Mg-2Zn-1Ca extracts. The release of Mg, Zn and Ca ions in culture media had no toxic impacts on ASCs viability and proliferation. Mg-2Zn-1Ca alloy can be suggested as a good candidate to be used in biomedical applications.
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Affiliation(s)
- Abbas Fazel Anvari-Yazdi
- Department of Biomedical Engineering, Materials and Biomaterials Research Center (MBMRC), Tehran, IR, Iran
| | - Kobra Tahermanesh
- Endometriosis and Gynecologic Disorders Research Center, Department of Ob. & Gyn., Rasoul-e Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, IR, Iran.
| | | | - Tahereh Talaei-Khozani
- Tissue Engineering Lab, Anatomy Department, School of Medicine, Shiraz University of Medical Sciences (SUMS), Shiraz, IR, Iran
| | - Mahboobeh Razmkhah
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences (SUMS), Shiraz, IR, Iran
| | - Seyedeh Mehr Abed
- School of Medicine, Yasuj University of Medical Sciences (YUMS), Yasuj, IR, Iran
| | - Maryam Sadat Mohtasebi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences (SUMS), Shiraz, IR, Iran
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