Elastomers for biomedical applications

Wetting on silicone surfaces

Silicone is frequently used as a model system to investigate and tune wetting on soft materials. Silicone is biocompatible and shows excellent thermal, chemical, and UV stability. Moreover, the mechanical properties of the surface can be easily varied by several orders of magnitude in a controlled manner. Polydimethylsiloxane (PDMS) is a popular choice for coating applications such as lubrication, self-cleaning, and drag reduction, facilitated by low surface energy. Aiming to understand the underlying interactions and forces, motivated numerous and detailed investigations of the static and dynamic wetting behavior of drops on PDMS-based surfaces. Here, we recognize the three most prevalent PDMS surface variants, namely liquid-infused (SLIPS/LIS), elastomeric, and liquid-like (SOCAL) surfaces. To understand, optimize, and tune the wetting properties of these PDMS surfaces, we review and compare their similarities and differences by discussing (i) the chemical and molecular structure, and (ii) the static and dynamic wetting behavior. We also provide (iii) an overview of methods and techniques to characterize PDMS-based surfaces and their wetting behavior. The static and dynamic wetting ridge is given particular attention, as it dominates energy dissipation, adhesion, and friction of sliding drops and influences the durability of the surfaces. We also discuss special features such as cloaking and wetting-induced phase separation. Key challenges and opportunities of these three surface variants are outlined.

Stretchable Tissue-Like Gold Nanowire Composites with Long-Term Stability for Neural Interfaces

Soft and stretchable nanocomposites can match the mechanical properties of neural tissue, thereby minimizing foreign body reactions to provide optimal stimulation and recording specificity. Soft materials for neural interfaces should simultaneously fulfill a wide range of requirements, including low Young's modulus (<<1 MPa), stretchability (≥30%), high conductivity (>> 1000 S cm-1), biocompatibility, and chronic stability (>> 1 year). Current nanocomposites do not fulfill the above requirements, in particular not the combination of softness and high conductivity. Here, this challenge is addressed by developing a scalable and robust synthesis route based on polymeric reducing agents for smooth, high-aspect ratio gold nanowires (AuNWs) of controllable dimensions with excellent biocompatibility. AuNW-silicone composites show outstanding performance with nerve-like softness (250 kPa), high conductivity (16 000 S cm-1), and reversible stretchability. Soft multielectrode cuffs based on the composite achieve selective functional stimulation, recordings of sensory stimuli in rat sciatic nerves, and show an accelerated lifetime stability of >3 years. The scalable synthesis method provides a chemically stable alternative to the widely used AgNWs, thereby enabling new applications within electronics, biomedical devices, and electrochemistry.

Batteryless implantable device with built-in mechanical clock for automated and precisely timed drug administration

Adherence to medication plays a crucial role in the effective management of chronic diseases. However, patients often miss their scheduled drug administrations, resulting in suboptimal disease control. Therefore, we propose an implantable device enabled with automated and precisely timed drug administration. Our device incorporates a built-in mechanical clock movement to utilize a clockwork mechanism, i.e., a periodic turn of the hour axis, enabling automatic drug infusion at precise 12-h intervals. The actuation principle relies on the sophisticated design of the device, where the rotational movement of the hour axis is converted into potential mechanical energy and is abruptly released at the exact moment for drug administration. The clock movement can be charged either automatically by mechanical agitations or manually by winding the crown, while the device remains implanted, thereby enabling the device to be used permanently without the need for batteries. When tested using metoprolol, an antihypertensive drug, in a spontaneously hypertensive animal model, the implanted device can deliver drug automatically at precise 12-h intervals without the need for further attention, leading to similarly effective blood pressure control and ultimately, prevention of ventricular hypertrophy as compared with scheduled drug administrations. These findings suggest that our device is a promising alternative to conventional methods for complex drug administration.

Lyotropic liquid crystal elastomers for drug delivery

Silicone elastomers like polydimethylsiloxane (PDMS) possess a combination of attractive material and biological properties motivating their widespread use in biomedical applications. Development of elastomers with capacity to deliver active therapeutic substances in the form of drugs is of particular interest to produce medical devices with added functionality. In this work, silicone-based lyotropic liquid crystal elastomers with drug-eluting functionality were developed using PDMS and triblock copolymer (diacrylated Pluronic F127, DA-F127). Various ternary PDMS-DA-F127-H₂O compositions were explored and evaluated. Three compositions were found to have specific properties of interest and were further investigated for their nanostructure, mechanical properties, water retention capacity, and morphology. The ability of the elastomers to encapsulate and release polar and nonpolar substances was demonstrated using vancomycin and ibuprofen as model drugs. It was shown that the materials could deliver both types of drugs with a sustained release profile for up to 6 and 5 days for vancomycin and ibuprofen, respectively. This works demonstrates a lyotropic liquid crystal, silicone-based elastomer with tailorable mechanical properties, water retention capacity and ability to host and release polar and nonpolar active substances.

Enhanced Rupture Force in a Cut-Dispersed Double-Network Hydrogel

The Kirigami approach is an effective way to realize controllable deformation of intelligent materials via introducing cuts into bulk materials. For materials ranging from ordinary stiff materials such as glass, ceramics, and metals to soft materials, including ordinary hydrogels and elastomers, all of them are all sensitive to the presence of cuts, which usually act as defects to deteriorate mechanical properties. Herein, we study the influence of the cuts on the mechanical properties by introducing "dispersed macro-scale cuts" into a model tough double network (DN) hydrogel (named D-cut gel), which consists of a rigid and brittle first network and a ductile stretchable second network. For comparison, DN gels with "continuous cuts" having the same number of interconnected cuts (named C-cut gel) were chosen. The fracture tests of D-cut gel and C-cut gel with different cut patterns were performed. The fracture observation revealed that crack blunting occurred at each cut tip, and a large wrinkle-like zone was formed where the wrinkles were parallel to the propagation direction of the cut. By utilizing homemade circular polarizing optical systems, we found that introducing dispersed cuts increases the rupture force by homogenizing the stress around the crack tip surrounding every cut, which reduces stress concentration in one certain cut. We believe this work reveals the fracture mechanism of tough soft materials with a kirigami cut structure, which should guide the design of advanced soft and tough materials along this line.

Multifunctional Surface Modification of PDMS for Antibacterial Contact Killing and Drug-Delivery of Polar, Nonpolar, and Amphiphilic Drugs

Medical device-associated infections pose major clinical challenges that emphasize the need for improved anti-infective biomaterials. Polydimethylsiloxane (PDMS), a frequently used elastomeric biomaterial in medical devices, is inherently prone to bacterial attachment and associated infection formation. Here, PDMS surface modification strategy is presented consisting of a cross-linked lyotropic liquid crystal hydrogel microparticle coating with antibacterial functionality. The microparticle coating composed of cross-linked triblock copolymers (diacrylated Pluronic F127) was deposited on PDMS by physical immobilization via interpenetrating polymer network formation. The formed coating served as a substrate for covalent immobilization of a potent antimicrobial peptide (AMP), RRPRPRPRPWWWW-NH₂, yielding high contact-killing antibacterial effect against Staphylococcus epidermidis and Staphylococcus aureus. Additionally, the coating was assessed for its ability to selectively host polar, amphiphilic, and nonpolar drugs, resulting in sustained release profiles. The results of this study put forward a versatile PDMS modification strategy for both contact-killing antibacterial surface properties and drug-delivery capabilities, offering a solution for medical device-associated infection prevention.

Magnetic Soft Materials and Robots

In conventional classification, soft robots feature mechanical compliance as the main distinguishing factor from traditional robots made of rigid materials. Recent advances in functional soft materials have facilitated the emergence of a new class of soft robots capable of tether-free actuation in response to external stimuli such as heat, light, solvent, or electric or magnetic field. Among the various types of stimuli-responsive materials, magnetic soft materials have shown remarkable progress in their design and fabrication, leading to the development of magnetic soft robots with unique advantages and potential for many important applications. However, the field of magnetic soft robots is still in its infancy and requires further advancements in terms of design principles, fabrication methods, control mechanisms, and sensing modalities. Successful future development of magnetic soft robots would require a comprehensive understanding of the fundamental principle of magnetic actuation, as well as the physical properties and behavior of magnetic soft materials. In this review, we discuss recent progress in the design and fabrication, modeling and simulation, and actuation and control of magnetic soft materials and robots. We then give a set of design guidelines for optimal actuation performance of magnetic soft materials. Lastly, we summarize potential biomedical applications of magnetic soft robots and provide our perspectives on next-generation magnetic soft robots.

Star-Shaped Polydimethylsiloxanes with Organocyclotetrasilsesquioxane Branching-Out Centers: Synthesis and Properties

New non-crystallizable low-dispersity star-shaped polydimethylsiloxanes (PDMS) containing stereoregular cis-tetra(organo)(dimethylsiloxy)cyclotetrasiloxanes containing methyl-, tolyl- and phenyl-substituents at silicon atoms and the mixture of four stereoisomers of tetra[phenyl(dimethylsiloxy)]cyclotetrasiloxane as the cores were synthesized. Their thermal and viscous properties were studied. All synthesized compounds were characterized by a complex of physicochemical analysis methods: nuclear magnetic resonance (NMR), FT-IR spectroscopy, gel permeation chromatography (GPC), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), viscometry in solution, rheometry, and Langmuir trough study.

A Narrative Review of u-HA/PLLA, a Bioactive Resorbable Reconstruction Material: Applications in Oral and Maxillofacial Surgery

The advent of bioresorbable materials to overcome limitations and replace traditional bone-reconstruction titanium-plate systems for bone fixation, thus achieving greater efficiency and safety in medical and dental applications, has ushered in a new era in biomaterial development. Because of its bioactive osteoconductive ability and biocompatibility, the forged composite of uncalcined/unsintered hydroxyapatite and poly L-lactic acid (u-HA/PLLA) has attracted considerable interest from researchers in bone tissue engineering, as well as from clinicians, particularly for applications in maxillofacial reconstructive surgery. Thus, various in vitro studies, in vivo studies, and clinical trials have been conducted to investigate the feasibility and weaknesses of this biomaterial in oral and maxillofacial surgery. Various technical improvements have been proposed to optimize its advantages and limit its disadvantages. This narrative review presents an up-to-date, comprehensive review of u-HA/PLLA, a bioactive osteoconductive and bioresorbable bone-reconstruction and -fixation material, in the context of oral and maxillofacial surgery, notably maxillofacial trauma, orthognathic surgery, and maxillofacial reconstruction. It simultaneously introduces new trends in the development of bioresorbable materials that could used in this field. Various studies have shown the superiority of u-HA/PLLA, a third-generation bioresorbable biomaterial with high mechanical strength, biocompatibility, and bioactive osteoconductivity, compared to other bioresorbable materials. Future developments may focus on controlling its bioactivity and biodegradation rate and enhancing its mechanical strength.

Implantable and Degradable Thermoplastic Elastomer

Biodegradable and implantable materials having elastomeric properties are highly desirable for many biomedical applications. Here, we report that poly(lactide)-co-poly(β-methyl-δ-valerolactone)-co-poly(lactide) (PLA-PβMδVL-PLA), a thermoplastic triblock poly(α-ester), has combined favorable properties of elasticity, biodegradability, and biocompatibility. This material exhibits excellent elastomeric properties in both dry and aqueous environments. The elongation at break is approximately 1000%, and stretched specimens completely recover to their original shape after force is removed. The material is degradable both in vitro and in vivo; it degrades more slowly than poly(glycerol sebacate) and more rapidly than poly(caprolactone) in vivo. Both the polymer and its degradation product show high cytocompatibility in vitro. The histopathological analysis of PLA-PβMδVL-PLA specimens implanted in the gluteal muscle of rats for 1, 4, and 8 weeks revealed similar tissue responses as compared with poly(glycerol sebacate) and poly(caprolactone) controls, two widely accepted implantable polymers, suggesting that PLA-PβMδVL-PLA can potentially be used as an implantable material with favorable in vivo biocompatibility. The thermoplastic nature allows this elastomer to be readily processed, as demonstrated by the facile fabrication of the substrates with topographical cues to enhance muscle cell alignment. These properties collectively make this polymer potentially highly valuable for applications such as medical devices and tissue engineering scaffolds.

The surface topography of silicone breast implants mediates the foreign body response in mice, rabbits and humans

Silicone is widely used in chronic implants and is generally perceived to be safe. However, textured breast implants have been associated with immune-related complications, including malignancies. Here, by examining for up to one year the foreign body response and capsular fibrosis triggered by miniaturized or full-scale clinically approved breast implants with different surface topography (average roughness, 0-90 μm) placed in the mammary fat pads of mice or rabbits, respectively, we show that surface topography mediates immune responses to the implants. We also show that the surface surrounding human breast implants collected during revision surgeries also differentially alters the individual's immune responses to the implant. Moreover, miniaturized implants with an average roughness of 4 μm can largely suppress the foreign body response and fibrosis (but not in T-cell-deficient mice), and that tissue surrounding these implants displayed higher levels of immunosuppressive FOXP3⁺ regulatory T cells. Our findings suggest that, amongst the topographies investigated, implants with an average roughness of 4 μm provoke the least amount of inflammation and foreign body response.

Highly Stretchable Fully Biomass Autonomic Self-Healing Polyamide Elastomers and Their Foam for Selective Oil Absorption

Renewable polymers with self-healing ability, excellent elongation, hydrophobicity, and selective oil absorption attributes are of interest for an extensive range of applications, such as e-skin, soft robots, wearable devices, and cleaning up oil spills. Herein, two fully renewable eco-friendly polyamide (PA)-based self-healing elastomers (namely, PA36,IA, and PA36,36) were prepared by a facile and green one-pot melt polycondensation of itaconic acid (IA), PripolTM 1009, and PriamineTM 1075 monomers. The molecular structures of these PAs were analyzed by FITR, 1H NMR, and 13C NMR. The distinct structure of these PAs shows superior strain values (above 2300%) and high ambient temperature autonomous self-healing ability. Interestingly, the synthesized renewable PA36,36 showed zero water absorption values and hydrophobic properties with a contact angle of θ = 91° compared to the synthesized PA36,IA and other previously reported PAs. These excellent attributes are due to the low concentration of amide groups, the highly entangled main chains, the intermolecular diffusion, the manifold dangling chains, and the numerous reversible physical bonds within the renewable PAs. Furthermore, the hydrophobic properties may aid in the selective oil absorption of the PA36,36-based foam, for which PA36,36 foam is produced by the green supercritical carbon dioxide (scCO2) batch foaming process. The PA36,36 foam with a microporous cellular structure showed better absorption capacity and high stability in repeated use. Due to these advantages, these bio-based PAs have potential for the production of eco-friendly self-healing materials, superabsorbent foams, and other polymeric materials.

Heterogeneous Double Metal Cyanide Catalyzed Synthesis of Poly(ε-caprolactone) Polyols for the Preparation of Thermoplastic Elastomers

A series of polycaprolactones (PCLs) with molecular weights of 950–10,100 g mol−1 and Ð of 1.10–1.87 have been synthesized via one-pot, solvent-free ring-opening polymerization (ROP) of ε-caprolactone (CL) using a heterogeneous double metal cyanide (DMC) catalyst. Various initiators, such as polypropylene glycol, ethylene glycol, propylene glycol, glycerol, and sorbitol, are employed to tune the number of hydroxyl end groups and properties of the resultant PCLs. Kinetic studies indicate that the DMC-catalyzed ROP of CL proceeds via a similar mechanism with the coordination polymerization. Branched PCLs copolymers are also synthesized via the DMC-catalyzed copolymerization of CL with glycidol. The α,ω-hydroxyl functionalized PCLs were successfully used as telechelic polymers to produce thermoplastic poly(ester-ester) and poly(ester-urethane) elastomers with well-balanced stress and strain properties.

Integrative microphysiological tissue systems of cancer metastasis to the liver

The liver is the most commonly involved organ in metastases from a wide variety of solid tumors. The use of biologically and cellularly complex liver tissue systems have shown that tumor cell behavior and therapeutic responses are modulated within the liver microenvironment and in ways distinct from the behaviors in the primary locations. These microphysiological systems have provided unexpected and powerful insights into the tumor cell biology of metastasis. However, neither the tumor nor the liver exist in an isolated tissue situation, having to function within a complete body and respond to systemic events as well as those in other organs. To examine the influence of one organ on the function of other tissues, microphysiological systems are being linked. Herein, we discuss extending this concept to tumor metastases by integrating complex models of the primary tumor with the liver metastatic environment. In addition, inflammatory organs and the immune system can be incorporated into these multi-organ systems to probe the effects on tumor behavior and cancer treatments.

Stretchable gold nanowire-based cuff electrodes for low-voltage peripheral nerve stimulation

Objective. Electrical stimulation of the peripheral nervous system (PNS) can treat various diseases and disorders, including the healing process after nerve injury. A major challenge when designing electrodes for PNS stimulation is the mechanical mismatch between the nerve and the device, which can lead to non-conformal contact, tissue damage and inefficient stimulation due to current leakage. Soft and stretchable cuff electrodes promise to tackle these challenges but often have limited performance and rely on unconventional materials. The aim of this study is to develop a high performance soft and stretchable cuff electrode based on inert materials for low-voltage nerve stimulation.Approach. We developed 50µm thick stretchable cuff electrodes based on silicone rubber, gold nanowire conductors and platinum coated nanowire electrodes. The electrode performance was characterized under strain cycling to assess the durability of the electrodes. The stimulation capability of the cuff electrodes was evaluated in anin vivosciatic nerve rat model by measuring the electromyography response to various stimulation pulses.Main results. The stretchable cuff electrodes showed excellent stability for 50% strain cycling and one million stimulation pulses. Saturated homogeneous stimulation of the sciatic nerve was achieved at only 200 mV due to the excellent conformability of the electrodes, the low conductor resistance (0.3 Ohm sq^-1), and the low electrode impedance.Significance. The developed stretchable cuff electrode combines favourable mechanical properties and good electrode performance with inert and stable materials, making it ideal for low power supply applications within bioelectronic medicine.

Membrane integration into PDMS-free microfluidic platforms for organ-on-chip and analytical chemistry applications

Membranes play a crucial role in many microfluidic systems, enabling versatile applications in highly diverse research fields. However, the tight and robust integration of membranes into microfluidic systems requires complex fabrication processes. Most integration approaches, so far, rely on polydimethylsiloxane (PDMS) as base material for the microfluidic chips. Several limitations of PDMS have resulted in the transition of many microfluidic approaches to PDMS-free systems using alternative materials such as thermoplastics. To integrate membranes in those PDMS-free systems, novel alternative approaches are required. This review provides an introduction into microfluidic systems applying membrane technology for analytical systems and organ-on-chip as well as a comprehensive overview of methods for the integration of membranes into PDMS-free systems. The overview and examples will provide a valuable resource and starting point for any researcher that is aiming at implementing membranes in microfluidic systems without using PDMS.

Biocompatible, Electroconductive, and Highly Stretchable Hybrid Silicone Composites Based on Few-Layer Graphene and CNTs

In this paper, we report a cost-effective and scalable approach to produce highly homogeneous graphene and CNT-based silicone composites with potential applications in diverse fields of research, including biosensors and wearable electronics. This approach includes the fabrication of hybrid fillers based on few-layer graphene and CNTs by water solution blending and manufacturing of graphene/CNT/PDMS composites through calendering in a three-roll mill. The influence of processing parameters, the graphene/CNT ratio, and hybrid filler loading was thoroughly investigated, and the optimal parameters for producing hybrid composites with superior electrical and mechanical properties were found. It was also confirmed that the graphene/CNT hybrid system exhibits a synergistic effect of non-covalent interactions between graphene sheets and CNT sidewalls. This synergistic effect prevents the aggregation of graphene sheets, facilitates the dispersion of graphene and CNTs in the silicone matrix, and contributes to the superior properties of hybrid composites compared to composites with either of these fillers alone.

Wholly Biobased, Highly Stretchable, Hydrophobic, and Self-healing Thermoplastic Elastomer

Renewable polymers with excellent stretchability and self-healing ability are interesting for a wide range of applications. A novel type of wholly biobased, self-healing, polyamide-based thermoplastic elastomer was synthesized using a fatty dimer acid and a fatty dimer amine, both containing multiple alkyl chains, through facile one-pot condensation polymerization under different polymerization times. The resulting elastomer shows superior stretchability (up to 2286%), high toughness, and excellent shape recovery after being stretched to different strains. This elastomer also displays high room-temperature autonomous self-healing efficiency after fracture and zero water uptake during water immersion. The highly entangled main chain, the multiple dangling chains, the abundant reversible physical bonds, the intermolecular diffusion, and the low ratio of amide to methylene group within the elastomer are responsible for these extraordinary properties. The polymerization time influences the properties of the elastomer. The use of the optimal self-healing thermoplastic elastomer in anticorrosion coating, piezoresistive sensing, and highly stretchable fibers is also demonstrated. The elastomer coating prevents stainless-steel products from corrosion in a salty environment due to its superhydrophobicity. The elastomer serves as a robust flexible substrate for creating self-healing piezoresistive sensors with excellent repeatability and self-healing efficiency. The elastomer fiber yarn can be stretched to 950% of its original length confirming its outstanding stretchability.

Lubrication dynamics of swollen silicones to limit long term fouling and microbial biofilms

Bacterial contamination and biofilm formation on medical devices remain a costly and serious healthcare problem. Silicone (polydimethylsiloxane, PDMS) elastomers are common biomaterials but are susceptible to bacterial surface contamination and biofilm growth. 'Self-lubricated' PDMS elastomers (iPDMS) have the potential to greatly reduce rates of cell attachment, biofilm formation and infection. Cross-linked PDMS elastomers immersed in PDMS oil swell to an equilibrium concentration to form a swollen network, and then form a surface liquid layer through syneresis. Herein we have measured the swelling and syneresis kinetics as a function of time, viscosity (1.5 to 10 cSt), and cross-linking density to optimize the surface lubricant layer formation, and resistance to biofouling. The lubricant layer thickness was measured in situ (optical profilometry and AFM) for flat and micro-textured surfaces, as a function of time and swelling ratio, to be in a range from 0.1 to 1 μm, and continuously increases with time. We show this continuous generation is likely due to a gradual, dynamic re-structuring of the elastomer network. Long term antifouling properties of (10 cSt) iPDMS were tested for Pseudomonas aeruginosa growth in a flow culture bioreactor, and after 30 d showed a 10³ to 10⁴ reduction of bacterial cell density for iPDMS compared to conventional PDMS elastomers. This long term performance and non-specific activity makes them highly suitable for biomedical devices, such as urinary catheters.

Multi-layer PDMS films having antifouling property for biomedical applications

Poly(dimethylsiloxane) (PDMS) elastomer is now a well-known material for packaging implantable biomedical micro-devices owing to unique bulk properties such as biocompatibility, low toxicity, excellent rheological properties, good flexibility, and mechanical stability. Despite the desirable bulk characteristics, PDMS is generally regarded as a high-flux material for oxygen and water vapor to penetrate compared with other polymeric barrier materials, which is related to the defect-induced penetration through the packaging coating prepared by the traditional deposition techniques. Besides, its hydrophobic nature causes serious fouling problems and limits the practical application of PDMS-based devices. In this work, the performance of silicone thin films as a packaging layer was improved by the fabrication of the roller-casted multiple thin layers to minimize a defect-induced failure. To confer hydrophilicity and cell fouling resistance, high-density and well-defined poly(oligo(ethylene glycol) methacrylate) (POEGMA) brushes were tethered via the surface-initiated atom transfer radical polymerization (SI-ATRP) technique on the roller-casted multiple thin PDMS layers. The characteristics of fabricated substrates were determined by static water contact angle measurement, X-ray photoelectron spectroscopy, and attenuated total reflection-Fourier transform infrared spectroscopy. In vitro cell behavior of POEGMA-grafted PDMS substrates was evaluated to examine cell-fouling resistance.

Biomaterials in Valvular Heart Diseases

Valvular heart disease (VHD) occurs as the result of valvular malfunction, which can greatly reduce patient's quality of life and if left untreated may lead to death. Different treatment regiments are available for management of this defect, which can be helpful in reducing the symptoms. The global commitment to reduce VHD-related mortality rates has enhanced the need for new therapeutic approaches. During the past decade, development of innovative pharmacological and surgical approaches have dramatically improved the quality of life for VHD patients, yet the search for low cost, more effective, and less invasive approaches is ongoing. The gold standard approach for VHD management is to replace or repair the injured valvular tissue with natural or synthetic biomaterials. Application of these biomaterials for cardiac valve regeneration and repair holds a great promise for treatment of this type of heart disease. The focus of the present review is the current use of different types of biomaterials in treatment of valvular heart diseases.

Freeform 3D printing of soft matters: recent advances in technology for biomedical engineering

In the last decade, an emerging three-dimensional (3D) printing technique named freeform 3D printing has revolutionized the biomedical engineering field by allowing soft matters with or without cells to be printed and solidified with high precision regardless of their poor self-supportability. The key to this freeform 3D printing technology is the supporting matrices that hold the printed soft ink materials during omnidirectional writing and solidification. This approach not only overcomes structural design restrictions of conventional layer-by-layer printing but also helps to realize 3D printing of low-viscosity or slow-curing materials. This article focuses on the recent developments in freeform 3D printing of soft matters such as hydrogels, cells, and silicone elastomers, for biomedical engineering. Herein, we classify the reported freeform 3D printing systems into positive, negative, and functional based on the fabrication process, and discuss the rheological requirements of the supporting matrix in accordance with the rheological behavior of counterpart inks, aiming to guide development and evaluation of new freeform printing systems. We also provide a brief overview of various material systems used as supporting matrices for freeform 3D printing systems and explore the potential applications of freeform 3D printing systems in different areas of biomedical engineering.

Recyclable and biocompatible microgel-based supporting system for positive 3D freeform printing of silicone rubber

Additive manufacturing (AM) of biomaterials has evolved from a rapid prototyping tool into a viable approach for the manufacturing of patient-specific implants over the past decade. It can tailor to the unique physiological and anatomical criteria of the patient's organs or bones through precise controlling of the structure during the 3D printing. Silicone elastomers, which is a major group of materials in many biomedical implants, have low viscosities and can be printed with a special AM platform, known as freeform 3D printing systems. The freeform 3D printing systems are composed of a supporting bath and a printing material. Current supporting matrices that are either commercially purchased or synthesized were usually disposed of after retrieval of the printed part. In this work, we proposed a new and improved supporting matrix comprises of synthesized calcium alginate microgels produced via encapsulation which can be recycled, reused, and recovered for multiple prints, hence minimizing wastage and cost of materials. The dehydration tolerance of the calcium alginate microgels was improved through physical means by the addition of glycerol and chemical means by developing new calcium alginate microgels encapsulated with glycerol. The recyclability of the heated calcium alginate microgels was also enhanced by a rehydration step with sodium chloride solution and a recovery step with calcium chloride solution via the ion exchange process. We envisaged that our reusable and recyclable biocompatible calcium alginate microgels can save material costs, time, and can be applied in various freeform 3D printing systems.

Erroneous or Arrhenius: A Degradation Rate-Based Model for EPDM during Homogeneous Ageing

To improve the predictive capability of long-term stress relaxation of elastomers during thermo-oxidative ageing, a method to separate reversible and irreversible processes was adopted. The separation is performed through the analysis of compression set after tempering. On the basis of this separation, a numerical model for long-term stress relaxation during homogeneous ageing is proposed. The model consists of an additive contribution of physical and chemical relaxation. Computer simulations of compression stress relaxation were performed for long ageing times and the results were validated with the Arrhenius treatment, the kinetic study and the time-temperature superposition technique based on experimental data. For chemical relaxation, two decay functions are introduced each with an activation energy and a degradative process. The first process with the lower activation energy dominates at lower ageing times, while the second one with the higher activation energy at longer ageing times. A degradation-rate based model for the evolution of each process and its contribution to the total system during homogeneous ageing is proposed. The main advantage of the model is the possibility to quickly validate the interpolation at lower temperatures within the range of slower chemical processes without forcing a straight-line extrapolation.

A strategy to control colonization of pathogens: embedding of lactic acid bacteria on the surface of urinary catheter

Indwelling urinary catheterization is one of the major causes of urinary tract infection (UTI) in hospitalized patients worldwide. A catheter serves as a surface for the colonization and formation of biofilm by UTI-related pathogenic bacteria. To combat the biofilm formation on its surface, several strategies have already been employed such as coating it with antibiofilm and antimicrobial compounds. For instance, the application of lactic acid bacteria (LAB) offers a potential strategy for the treatment of biofilm formation on the surface of the urinary catheter due to its ability to kill the pathogenic bacteria. The killing of pathogenic bacteria by LAB occurs via the production of antimicrobial compounds such as lactic acid, bacteriocin, and hydrogen peroxide. LAB also displays a competitive exclusion mechanism to prevent the adhesion of pathogens on the surfaces. Hence, LAB has been extensively applied as a bacteriotherapy to combat infectious diseases. Several strategies have been employed to attach LAB to a surface, but its easy detachment during long time exposure becomes one of the drawbacks in its application. Here, we have proposed a novel strategy for its adhesion on the surface of the urinary catheter with the utilization of mannose-specific adhesin (Msa) protein in a way similar as uropathogenic bacteria interacts between Msa present on the tip of the type I fimbriae/pilus and the mannose moieties on the host epithelial cell surfaces. KEY POINTS: • Urinary tract infection (UTI) is one of the common hospital-acquired infections, which is associated with the application of an indwelling urinary catheter. • Based on the competitive exclusions properties of LAB, attachment of the LAB on the catheter surface would be a promising approach to control the formation of pathogenic biofilm. • The strategy employed for the adhesion of LAB is via a covalent interaction of its mannose-specific adhesin (Msa) protein to the mannose residues grafted on the catheter surface.

Tough Ordered Mesoporous Elastomeric Biomaterials Formed at Ambient Conditions

Synthetic dry elastomers are randomly cross-linked polymeric networks with isotropic and unordered higher-level structural features. However, their growing use as soft-tissue biomaterials has demanded the need for an ordered and anisotropic nano-micro (or) mesoarchitecture, which is crucial for imparting specific properties such as hierarchical toughening, anisotropic mechanics, sustained drug delivery, and directed tissue growth. High processing cost, poor control in 3D, and compromised mechanical properties have made it difficult to synthesize tough and dry macroscopic elastomers with well-organized nano-microstructures. Inspired from biological design principles, we report a tough ordered mesoporous elastomer formed via bottom-up lyotropic self-assembly of noncytotoxic, polymerizable amphiphilic triblock copolymers and hydrophobic polymers. The elastomer is cross-linked using covalent cross-links and physical hydrophobic entanglements that are organized in a periodic manner at the nanoscale. This transforms into a well-ordered hexagonal arrangement of nanofibrils that are highly oriented at the micron scale, further organized as 3D macroscale objects. The ordered nano-microstructure and molecular multinetwork endows the elastomer with hierarchical toughening while possessing excellent stiffness and elongation comparable to engineering elastomers like silicone and vulcanized rubber. Processing of the elastomer is performed at ambient conditions using 3D printing and photo-cross-linking, which is fast and energy efficient and enables production of complex 3D objects with tailorable sub-millimeter features such as macroporosity. Furthermore, the periodic and amphiphilic nanostructure permits functionalization of the elastomer with secondary components such as inorganic nanoparticles or drug molecules, enabling complementary mechanical properties such as high stiffness and functional capabilities such as in localized drug delivery applications.

A Review: Electrode and Packaging Materials for Neurophysiology Recording Implants

To date, a wide variety of neural tissue implants have been developed for neurophysiology recording from living tissues. An ideal neural implant should minimize the damage to the tissue and perform reliably and accurately for long periods of time. Therefore, the materials utilized to fabricate the neural recording implants become a critical factor. The materials of these devices could be classified into two broad categories: electrode materials as well as packaging and substrate materials. In this review, inorganic (metals and semiconductors), organic (conducting polymers), and carbon-based (graphene and carbon nanostructures) electrode materials are reviewed individually in terms of various neural recording devices that are reported in recent years. Properties of these materials, including electrical properties, mechanical properties, stability, biodegradability/bioresorbability, biocompatibility, and optical properties, and their critical importance to neural recording quality and device capabilities, are discussed. For the packaging and substrate materials, different material properties are desired for the chronic implantation of devices in the complex environment of the body, such as biocompatibility and moisture and gas hermeticity. This review summarizes common solid and soft packaging materials used in a variety of neural interface electrode designs, as well as their packaging performances. Besides, several biopolymers typically applied over the electrode package to reinforce the mechanical rigidity of devices during insertion, or to reduce the immune response and inflammation at the device-tissue interfaces are highlighted. Finally, a benchmark analysis of the discussed materials and an outlook of the future research trends are concluded.

Exploring polycaprolactone in tracheal surgery: A scoping review of in-vivo studies

INTRODUCTION

Tracheal pathology can be life-threatening if not managed appropriately. There are still some surgical limitations today for certain pathologies, such as in severe tracheomalacia, or when long segments of trachea need to be resected. Poly(ε-caprolactone) (PCL) is a polymer that has recently gained popularity for its use in tracheal surgeries in animal models and in certain human pediatric cases in hopes of addressing these difficult situations. PCL can be 3D printed or manufactured through molds to create tracheal stents, splints, patches and even to reconstruct full circumferential tracheal defects.

OBJECTIVE

To perform a scoping review, and explore insights into the applications of PCL for tracheal surgeries in-vivo.

METHODS

A literature search in Embase, MEDLINE, and BIOSIS was performed to include all articles available prior to December 21, 2018 without any language restrictions. We included all original research that investigated the use of a PCL implant, stent, splint, scaffold, or graft in tracheal surgeries in-vivo. Assessment of all articles were performed by two independent authors prior to inclusion for analysis.

RESULTS

A total of 27 articles were included in the study. All articles were original research studies, primarily consisting of interventional studies (92.4%), there was also 2 case reports (7.4%). Articles were published in the last decade, publications range from 2009 to 2019. The most common animal model used for the tracheal surgeries were the New Zealand rabbits (n = 19, 70%). Two studies (7%) also described the use PCL in a total of 4 human cases. To investigate the PCL reconstructed airways, histology and bronchoscopy were the most commonly implemented methods of analysis in 88.9% and 70.4% respectively. Airway analysis was also done using imaging modalities including CT scan (n = 9, 33.3%), MRI (n = 2, 7.4%), X-ray (n = 1, 3.7%). 17 (62.9%) of the studies used 3D printing processes to create their PCL implants.

CONCLUSIONS

Overall, this review demonstrates the feasibility of PCL in tracheal reconstruction and tracheal stenting/splinting. It highlights common trends and the limitations of the literature thus far on this topic.

Evaluating Efficacy of Antimicrobial and Antifouling Materials for Urinary Tract Medical Devices: Challenges and Recommendations

In Europe, the mean incidence of urinary tract infections in intensive care units is 1.1 per 1000 patient-days. Of these cases, catheter-associated urinary tract infections (CAUTI) account for 98%. In total, CAUTI in hospitals is estimated to give additional health-care costs of £1-2.5 billion in the United Kingdom alone. This is in sharp contrast to the low cost of urinary catheters and emphasizes the need for innovative products that reduce the incidence rate of CAUTI. Ureteral stents and other urinary-tract devices suffer similar problems. Antimicrobial strategies are being developed, however, the evaluation of their efficacy is very challenging. This review aims to provide considerations and recommendations covering all relevant aspects of antimicrobial material testing, including surface characterization, biocompatibility, cytotoxicity, in vitro and in vivo tests, microbial strain selection, and hydrodynamic conditions, all in the perspective of complying to the complex pathology of device-associated urinary tract infection. The recommendations should be on the basis of standard assays to be developed which would enable comparisons of results obtained in different research labs both in industry and in academia, as well as provide industry and academia with tools to assess the antimicrobial properties for urinary tract devices in a reliable way.

Antifouling Photograftable Zwitterionic Coatings on PDMS Substrates

The foreign body response (FBR) to implantable materials can negatively impact performance of medical devices such as the cochlear implant. Engineering surfaces that resist the FBR could lead to enhanced functionality including potentially improving outcomes for cochlear implant recipients through reduction in fibrosis. In this work, we coat poly(dimethylsiloxane) (PDMS) surfaces with two zwitterionic polymers, poly(sulfobetaine methacrylate) (pSBMA) and poly(carboxybetaine methacrylate) (pCBMA), using a simultaneous photografting/photo-cross-linking process to produce a robust grafted zwitterionic hydrogel. reduce nonspecific protein adsorption, the first step of the FBR. The coating process uses benzophenone, a photografting agent and type II photoinitiator, to covalently link the cross-linked zwitterionic thin film to the PDMS surface. As the concentration of benzophenone on the surface increases, the adhesive strength of the zwitterionic thin films to PDMS surfaces increases as determined by shear adhesion. Additionally, with increased concentration of the adsorbed benzophenone, failure of the system changes from adhesive delamination to cohesive failure within the hydrogel, demonstrating that durable adhesive bonds are formed from the photografting process. Interestingly, antifouling properties of the zwitterionic polymers are preserved with significantly lower levels of nonspecific protein adsorption on zwitterion hydrogel-coated samples compared to uncoated controls. Fibroblast adhesion is also dramatically reduced on coated substrates. These results show that cross-linked pSBMA and pCBMA hydrogels can be readily photografted to PDMS substrates and show promise in potentially changing the fibrotic response to implanted biomaterials.

Application of functional diols derived from pentaerythritol as chain extenders in the synthesis of novel thermoplastic polyester-urethane elastomers

Functional thermoplastic poly(ester-urethane)s (TPEUs) reported herein offer a wide range of thermal, mechanical and degradation properties which can be fine-tuned through a selection of post-polymerisation reactions.

Quantifying the interactions between biomimetic biomaterials - collagen I, collagen IV, laminin 521 and cellulose nanofibrils - by colloidal probe microscopy

Biomaterials of different nature have been and are widely studied for various biomedical applications. In many cases, biomaterial assemblies are designed to mimic biological systems. Although biomaterials have been thoroughly characterized in many aspects, not much quantitative information on the molecular level interactions between different biomaterials is available. That information is very important, on the one hand, to understand the properties of biological systems and, on the other hand, to develop new composite biomaterials for special applications. This work presents a systematic, quantitative analysis of self- and cross-interactions between films of collagen I (Col I), collagen IV (Col IV), laminin (LN-521), and cellulose nanofibrils (CNF), that is, biomaterials of different nature and structure that either exist in biological systems (e.g., extracellular matrices) or have shown potential for 3D cell culture and tissue engineering. Direct surface forces and adhesion between biomaterials-coated spherical microparticles and flat substrates were measured in phosphate-buffered saline using an atomic force microscope and the colloidal probe technique. Different methods (Langmuir-Schaefer deposition, spin-coating, or adsorption) were applied to completely coat the flat substrates and the spherical microparticles with homogeneous biomaterial films. The adhesion between biomaterials films increased with the time that the films were kept in contact. The strongest adhesion was observed between Col IV films, and between Col IV and LN-521 films after 30 s contact time. In contrast, low adhesion was measured between CNF films, as well as between CNF and LN-521 films. Nevertheless, a good adhesion between CNF and collagen films (especially Col I) was observed. These results increase our understanding of the structure of biological systems and can support the design of new matrices or scaffolds where different biomaterials are combined for diverse biological or medical applications.

Toward Self-Control Systems for Neurogenic Underactive Bladder: A Triboelectric Nanogenerator Sensor Integrated with a Bistable Micro-Actuator

Aging, neurologic diseases, and diabetes are a few risk factors that may lead to underactive bladder (UAB) syndrome. Despite all of the serious consequences of UAB, current solutions, the most common being ureteric catheterization, are all accompanied by serious shortcomings. The necessity of multiple catheterizations per day for a physically able patient not only reduces the quality of life with constant discomfort and pain but also can end up causing serious complications. Here, we present a bistable actuator to empty the bladder by incorporating shape memory alloy components integrated on flexible polyvinyl chloride sheets. The introduction of two compression and restoration phases for the actuator allows for repeated actuation for a more complete voiding of the bladder. The proposed actuator exhibits one of the highest reported voiding percentages of up to 78% of the bladder volume in an anesthetized rat after only 20 s of actuation. This amount of voiding is comparable to the common catheterization method, and its one time implantation onto the bladder rectifies the drawbacks of multiple catheterizations per day. Furthermore, the scaling of the device for animal models larger than rats can be easily achieved by adjusting the number of nitinol springs. For neurogenic UAB patients with degraded nerve function as well as degenerated detrusor muscle, we integrate a flexible triboelectric nanogenerator sensor with the actuator to detect the fullness of the bladder. The sensitivity of this sensor to the filling status of the bladder shows its capability for defining a self-control system in the future that would allow autonomous micturition.

Probiotic E. coli Nissle 1917 biofilms on silicone substrates for bacterial interference against pathogen colonization

Bacterial interference is an alternative strategy to fight against device-associated bacterial infections. Pursuing this strategy, a non-pathogenic bacterial biofilm is used as a live, protective barrier to fence off pathogen colonization. In this work, biofilms formed by probiotic Escherichia coli strain Nissle 1917 (EcN) are investigated for their potential for long-term bacterial interference against infections associated with silicone-based urinary catheters and indwelling catheters used in the digestive system, such as feeding tubes and voice prostheses. We have shown that EcN can form stable biofilms on silicone substrates, particularly those modified with a biphenyl mannoside derivative. These biofilms greatly reduced the colonization by pathogenic Enterococcus faecalis in Lysogeny broth (LB) for 11days.

STATEMENT OF SIGNIFICANCE

Bacterial interference is an alternative strategy to fight against device-associated bacterial infections. Pursuing this strategy, we use non-pathogenic bacteria to form a biofilm that serves as a live, protective barrier against pathogen colonization. Herein, we report the first use of preformed probiotic E. coli Nissle 1917 biofilms on the mannoside-presenting silicone substrates to prevent pathogen colonization. The biofilms serve as a live, protective barrier to fence off the pathogens, whereas current antimicrobial/antifouling coatings are subjected to gradual coverage by the biomass from the rapidly growing pathogens in a high-nutrient environment. It should be noted that E. coli Nissle 1917 is commercially available and has been used in many clinical trials. We also demonstrated that this probiotic strain performed significantly better than the non-commercial, genetically modified E. coli strain that we previously reported.

A brief review of recent developments in the designs that prevent bio-fouling on silicon and silicon-based materials

Silicon and silicon-based materials are essential to our daily life. They are widely used in healthcare and manufacturing. However, silicon and silicon-based materials are susceptible to bio-fouling, which is of great concern in numerous applications. To date, interdisciplinary research in surface science, polymer science, biology, and engineering has led to the implementation of antifouling strategies for silicon-based materials. However, a review to discuss those antifouling strategies for silicon-based materials is lacking. In this article, we summarized two major approaches involving the functionalization of silicon and silicon-based materials with molecules exhibiting antifouling properties, and the fabrication of silicon-based materials with nano- or micro-structures. Both approaches lead to a significant reduction in bio-fouling. We critically reviewed the designs that prevent fouling due to proteins, bacteria, and marine organisms on silicon and silicon-based materials. Graphical abstractStrategies used in the designs that prevent bio-fouling on silicon and silicon-based materials.

Physical and Mechanical Evaluation of Silicone-Based Double-Layer Adhesive Patch Intended for Keloids and Scar Treatment Therapy

Growing interest in silicone elastomers for pharmaceutical purposes is due to both their beneficial material effect for scar treatment and their potential as drug carriers. Regarding their morphological structure, silicone polymers possess unique properties, which enable a wide range of applicability possibilities. The present study focused on developing a double-layer adhesive silicone film (DLASil) by evaluating its physical and mechanical properties, morphology, and stability. DLASil suitability for treatment of scars and keloids was evaluated by measurement of tensile strength, elasticity modulus, and elongation. The results indicated that mechanical and physical properties of the developed product were satisfying.