Titanium containing amorphous hydrogenated carbon films (a-C: H/Ti): surface analysis and evaluation of cellular reactions using bone marrow cell cultures in vitro

Amorphous hydrogenated carbon (a-C : H) coatings, also called diamond-like carbon (DLC), have many properties required for a protective coating material in biomedical applications. The purpose of this study is to evaluate a new surface coating for bone-related implants by combining the hardness and inertness of a-C : H films with the biological acceptance of titanium. For this purpose, different amounts of titanium were incorporated into a-C : H films by a combined radio frequency (rf) and magnetron sputtering set-up. The X-ray photoelectron spectroscopy (XPS) of air-exposed a-C : H/titanium (a-C : H/Ti) films revealed that the films were composed of TiO2 and TiC embedded in and connected to an a-C : H matrix. Cell culture tests using primary adult rat bone marrow cell cultures (BMC) were performed to determine effects on cell number and on osteoblast and osteoclast differentiation. By adding titanium to the carbon matrix, cellular reactions such as increased proliferation and reduced osteoclast-like cell activity could be obtained, while these reactions were not seen on pure a-C : H films and on glass control samples. In summary, a-C : H/Ti could be a valuable coating for bone implants, by supporting bone cell proliferation while reducing osteoclast-like cell activation.

Tissue engineering scaffolds using superstructures

Here, scaffolds as cell and tissue carriers are approached from an engineering point of view, emphasizing material superstructuring in the design of supports. Superstructure engineering provides optimal spatial and nutritional conditions for cell maintenance by the arrangement of structural elements (e.g. pores or fibres) so as to vary the order of cell to cell contact. This approach is illustrated in the design of several scaffolds: knitted fabrics as three-dimensional superstructures for optimized osteosynthesis implants, a new injectable open porous implant system, an angiopolar non-degradable ceramic cell carrier, and an injectable or microsurgically implantable entangled carrier system. The implications for tissue engineering are discussed.

Mechanical properties and in vitro behavior of nanofiber-hydrogel composites for tissue engineering applications

Hydrogel-based biomaterial systems have great potential for tissue reconstruction by serving as temporary scaffolds and cell delivery vehicles for tissue engineering (TE). Hydrogels have poor mechanical properties and their rapid degradation limits the development and application of hydrogels in TE. In this study, nanofiber reinforced composite hydrogels were fabricated by incorporating electrospun poly(ε-caprolactone) (PCL)/gelatin 'blend' or 'coaxial' nanofibers into gelatin hydrogels. The morphological, mechanical, swelling and biodegradation properties of the nanocomposite hydrogels were evaluated and the results indicated that the moduli and compressive strengths of the nanofiber reinforced hydrogels were remarkably higher than those of pure gelatin hydrogels. By increasing the amount of incorporated nanofibers into the hydrogel, the Young's modulus of the composite hydrogels increased from 3.29 ± 1.02 kPa to 20.30 ± 1.79 kPa, while the strain at break decreased from 66.0 ± 1.1% to 52.0 ± 3.0%. Compared to composite hydrogels with coaxial nanofibers, those with blend nanofibers showed higher compressive strength and strain at break, but with lower modulus and energy dissipation properties. Biocompatibility evaluations of the nanofiber reinforced hydrogels were carried out using bone marrow mesenchymal stem cells (BM-MSCs) by cell proliferation assay and immunostaining analysis. The nanocomposite hydrogel with 25 mg ml(-1) PCL/gelatin 'blend' nanofibers (PGB25) was found to enhance cell proliferation, indicating that the 'nanocomposite hydrogels' might provide the necessary mechanical support and could be promising cell delivery systems for tissue regeneration.

Inhibition of Neointima Formation by a Novel Drug-Eluting Stent System That Allows for Dose-Adjustable, Multiple, and On-Site Stent Coating

OBJECTIVE

The risk of in-stent restenosis can be considerably reduced by stents eluting cytostatic compounds. We created a novel drug-eluting stent system that includes several new features in the rapidly evolving field of stent-based drug delivery.

METHODS AND RESULTS

The aim of the present study was the preclinical evaluation of a stent-coating system permitting individual, on-site coating of stents with a unique microporous surface allowing for individualizable, dose-adjustable, and multiple coatings with identical or various compounds, designated ISAR (individualizable drug-eluting stent system to abrogate restenosis). Stents were coated with 0.75% rapamycin solution, and high-performance liquid chromatography (HPLC)-based determination of drug release profile indicated drug release for >21 days. Rapamycin-eluting microporous (REMP) stents implanted in porcine coronary arteries were safe. To determine the efficacy of REMP stents, this novel drug-eluting stent platform was compared with the standard sirolimus-eluting stent. At 30 days, in-stent neointima formation in porcine coronary arteries was similar in both groups, yielding a significant decrease of neointimal area and injury-dependent neointimal thickness compared with bare-metal stents.

CONCLUSIONS

The ISAR drug-eluting stent platform as a novel concept for stent coating allows for a safe, effective, on-site stent coating process, thus justifying further clinical evaluation to decrease in-stent restenosis in humans.

Degradation of poly(D,L)lactide implants with or without addition of calciumphosphates in vivo

The study was aimed at examining the in vivo degradation of pure poly(D,L)lactide (PDLLA) or PDLLA with an admixture of calciumphosphates. One rod (20 x 3 x 2 mm) and one cube (3 x 2 x 2 mm) of pure PDLLA, PDLLA with tricalciumphosphate (PDLLA + TCP) or PDLLA with calciumhydrogenphosphate (PDLLA + CHP), respectively, were implanted into the dorsal muscles of 50 male Wistar Albino rats. After definite intervals (from 2nd to 72nd week), pH measurements were performed in the environment of the implants. Afterwards, the cubes with their surrounding tissues were excised for histological examinations, measurements of the outer dimensions and mechanical analyses of the explanted rods were performed. No drop of more than 0.1 pH units was detectable in the tissue surrounding any type of implants. No advantageous effect of the calciumphosphates could be proved. A mild foreign body reaction could be observed around PDLLA implants. After 72 weeks, pure PDLLA had been totally resorbed from the extracellular space, the degradation of calciumphosphate-enriched PDLLA was still in progress. A large amount of inflammations occurred in the tissues surrounding PDLLA with an admixture of slowly degrading TCP or CHP, leading to two abscesses and four fistulas at PDLLA + TCP, and two abscesses and three fistulas at PDLLA + CHP implantation site. Bending strength of pure PDLLA was constant up to the 4th week post-implantation and reduced to 60% of the initial value up to the 12th week. No traces of crystallinity could be observed during the degradation of PDLLA. As a conclusion of the study, complete resorption from the extracellular space and tissue tolerance of pure PDLLA is proved. An admixture of small calciumphosphate particles is not suitable to improve the biocompatibility of PDLLA but leads to a decrease in the mechanical characteristics.

Prevention of restenosis by a novel drug-eluting stent system with a dose-adjustable, polymer-free, on-site stent coating

AIMS

Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES system has been developed that permits individualized choice of the drug and dose to use for the given patient. The objective of this prospective dose finding study was to assess the feasibility, safety, and efficacy of a polymer-free on-site stent coating with increasing rapamycin doses.

METHODS AND RESULTS

In this dose finding study, 602 patients were sequentially enrolled in four groups: microporous bare metal stent (BMS), DES stents coated with a 0.5, 1.0, and 2.0% rapamycin solution. The angiographic in-segment restenosis rate at follow-up angiography was the primary study endpoint. In-segment restenosis was significantly reduced from 25.9% with BMS to 18.9, 17.2, and 14.7% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.024). Similarly, the need for target lesion revascularization at 1 year follow-up was reduced from 21.5% with BMS to 16.4, 12.6, and 8.8% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.006).

CONCLUSION

The placement of polymer-free stents coated on-site with rapamycin is feasible and safe. Furthermore, a dose-dependent efficacy in restenosis prevention is achievable with this new DES concept.

Degradation and applications of polyhydroxyalkanoates

A series of tests is available to study the biodegradation of plastic materials under either laboratory or field conditions. Most of the standard methods have been published by the American Society for Testing and Materials. All of them describe techniques to investigate the biodegradation of plastics under laboratory conditions. Microbially formed polyhydroxyalkanoates (PHAs) have been marketed recently as biodegradable plastics. However, currently only a few articles made from PHAs (e.g., bottles) are commercially available. A series of microorganisms (prokaryotes as well as eukaryotes) has been characterized as being able to degrade PHAs. With one exception (Ilyobacter delafieldii), all of them were isolated from aerobic environments. So far, over 10 different extracellular PHA depolymerases have been purified and characterized. Depolymerases that preferentially attack PHAs with monomer units other than 3-hydroxybutyrate have been found only in Pseudomonas fluorescens and Pseudomonas lemoignei.Key words: poly(3-hydroxybutyrate), polyhydroxyalkanoates, biodegradation, industrial applications.

Future directions in biomaterials

Biomaterials have made a great impact on medicine. However, numerous challenges remain. This paper discusses three representative areas involving important medical problems. First, drug delivery systems; major considerations include drug-polymer interactions, drug transformation, diffusion properties of drugs and, if degradation occurs, of polymer degradation products through polymer matrices developing a more complete understanding of matrix degradation in the case of erodible polymers and developing new engineered polymers designed for specific purposes such as vaccination or pulsatile release. Second, cell-polymer interactions, including the fate of inert polymers, the use of polymers as templates for tissue regeneration and the study of polymers which aid cell transplantation. Third, orthopaedic biomaterials, including basic research in the behaviour of chondrocytes, osteocytes and connective tissue-free interfaces and applied research involving computer-aided design of biomaterials and the creation of orthopaedic biomaterials.

Protein adsorption and monocyte activation on germanium nanopyramids

Germanium can form defect-free pyramidal islands on Si(1 0 0)-2 x 1 with a height of 15 nm and a width of 60 nm. Using chemical vapor deposition we have prepared substrates with different nanopyramid densities to study the impact on contact angles, protein adsorption and cell behavior. The advancing contact angle of a water droplet of millimeter size significantly raises with nanopyramid density. The dynamic contact angle measurements reveal that the substrate surface is highly hydrophilic. On such a surface the adsorption of hydrophilic proteins, i.e. albumin and globulin, is drastically increased by the presence of nanopyramids. More important, however, the globulin is inactive after adsorption on nanopyramid edges. This observation is supported by the cytokine release of IL-1beta and TNF-alpha of monocyte-like cell line U937. Consequently, the presence of nanopyramidal structures gives rise to less inflammatory reactions.

Surface activation of polyetheretherketone (PEEK) and formation of calcium phosphate coatings by precipitation

Plasma activation of polyetheretherketone (PEEK) surfaces and the influence on coating formation in a supersaturated calcium phosphate solution was investigated in this study. It was observed that plasma treatment in a N2/O2 plasma had a significant effect on the wettability of the PEEK surface. The contact angle decreased from 85 degrees to 25 degrees after plasma treatment. Cell culture testing with osteoblastic cell lines showed plasma activation not to be disadvantageous to cell viability. X-ray photoelectron spectroscopy (XPS) analysis was performed to characterize the chemical composition of the PEEK surfaces. It was observed that the O1s intensity increased with plasma activation time. At the C1s peak the appearance of a shoulder at higher binding energies was observed. Coating of PEEK was performed in a supersaturated calcium phosphate solution. Coating thicknesses of up to 50 microm were achieved after 24 days of immersion. Plasma activation followed by nucleation in a highly saturated hydroxyapatite solution had a positive effect on the growth rate of the layer on PEEK. Chemical analysis revealed that the coating consists of a carbonate-containing calcium phosphate.

Direct magnetic tubular cell seeding: a novel approach for vascular tissue engineering

Optimizing seeding efficiency, reducing delayed culture periods and mimicking native tissue architecture are crucial requirements for the development of seeding procedures in tissue engineering. In vascular applications, the tubular geometry of the grafts further hampers the efficient delivery of cells onto the scaffold. To overcome these limitations, a novel technology based upon the use of magnetic fields is presented in this study: a radial magnetic force drives the cells immediately onto the luminal surface of a tubular scaffold and immobilizes the cells on the substrate's surface promoting cell attachment. Human smooth muscle cells (SMCs) labeled with CD44 magnetic Dynabeads were successively seeded onto the luminal surface of a tubular shaped collagen membrane. After 5 h, one additional layer of human umbilical vein endothelial cells (HUVECs) labeled with CD31 magnetic Dynabeads was seeded onto the luminal SMCs. The co-culture was incubated during 5 days prior to analysis. Cell viability and expression profiles were preserved during the entire seeding process. Histological examination of the constructs highlighted densely packed multilayers of SMCs covered by a monolayer of endothelial cells. SEM inspection confirmed a heterotypic multilayer assembly formed by multiple layers of elongated SMCs covered by a single layer of endothelial cells. Seeding kinetics of HUVECs and SMCs showed over 90% seeding efficiency after 20 and 40 min magnetic exposure respectively. Magnetically induced cell seeding provides a valuable tool for rapid seeding procedures of tubular scaffolds while complying with the histological architecture of tissue.

Resorbable defect analog PLGA scaffolds using CO2 as solvent: structural characterization

After tooth extraction, the immediate wound treatment by implanting an exact copy of the root could prevent alveolar bone atrophy. The implant should have an interconnected porosity in order to promote tissue in-growth. This communication reports a novel method to realize such net-shaped porous scaffolds fabricated within a few minutes. Porosity and micro-architecture are evaluated by Hg-porosimetry and by image analysis of electron and light microscopy as well as by computed micro-tomography. The total porosity of the scaffold corresponds to (63 +/- 3)%, mainly related to open interconnected porosity. Micro-tomography, as a noninvasive 3D method, is best suited to uncover pores of about 100 microm, a diameter especially important for tissue in-growth. The differentiation between open and closed porosity, however, depends on the method chosen. This effect is attributed to the spherical pores with an orifice only detected in the 3D analysis. Consequently, the closed porosity is overestimated by 8% evaluating 2D images. Finally, the mean pore diameter is found to be 106 and 100 microm for 2D and 3D analysis, respectively. Although the porosity of the scaffold needs to be further optimized for clinical applications, the procedure proposed is a promising route in manufacturing open porous implants without the use of any organic solvent.

Partially degradable film/fabric composites: textile scaffolds for liver cell culture

In this study, a composite scaffold combining textile superstructures and biomimetic glycopolymers is introduced, which may allow engineering of organotypic liver tissue in vitro. Woven poly(ethylene therephtalat) (PET) fabrics were coated on one side with a thin biodegradable polymer film (poly[D-L-lactic-co-glycolic acid] PLGA), in order to obtain a polar structure. The composite structure ensured the stability of the membrane during in vitro degradation, independently of mesh size. Matrix porosity increased when a polymer blend matrix was used. For hepatocyte culturing studies, the scaffolds were additionally coated with an artificial glycopolymer (poly[N-p-vinylbenzyl-D-lactoamide], PVLA) in order to improve cell attachment. It was observed that formation of aggregates depends on the scaffold geometry as well as on the pretreatment and medium conditions. After 4 days in culture, the pores of the fabric were filled with aggregates illustrating the possibility of immobilizing hepatocyte aggregates in well-defined spatial configurations on textile structures.

Non-destructive three-dimensional evaluation of a polymer sponge by micro-tomography using synchrotron radiation

X-ray micro-tomography, a non-destructive technique is used to uncover the complex 3-D micro-architecture of a degradable polymer sponge designed for bone augmentation. The measurements performed at HASYLAB at DESY are based on a synchrotron radiation source resulting in a spatial resolution of about 5.4 microm. In the present communication we report the quantitative analysis of the porosity and of the pore architecture. First, we elucidate that synchrotron radiation at the photon energy of 9 keV has an appropriate cross section for this low-weight material. Modifications in sponge micro-architecture during measurement are not detected. Second, the treatment of the data, an amount of 2.5 Gbyte to generate binary data is described. We compare the 3-D with the 2-D analysis in a quantitative manner. The obtained values for the mean distance to material within the sponge calculated from 2-D and 3-D data of the whole tomogram differ significantly: 12.5 microm for 3-D and 17.6 microm for 2-D analysis. If the pores exhibit a spherical shape as frequently found, the derived mean pore diameter, however, is overestimated only by 6% in the 2-D image analysis with respect to the 3-D evaluation. This approach can be applied to different porous biomaterials and composites even in a hydrated state close to physiological conditions, where any surface preparation artifact is avoided.

Matrices for tissue engineering-scaffold structure for a bioartificial liver support system

This study proposes a new composite scaffold system. A woven polyethylenterephtalate (PET) fabric was coated on one side with a biodegradable PLGA film, in order to obtain a geometrically polarized scaffold structure for an bioartificial liver support system. The composite structure ensures the stability of the membrane during degradation of the membrane polymer. The mesh size of the composite does not significantly influence the degradation behavior. Hepatocyte culturing studies reveal that the formation of aggregates depends on the mesh size and on the pretreatment: The largest aggregates could be observed after 48 h when PVLA coating, large mesh size and EGF were combined. Thus, the combination of a geometrically structured, partially degradable scaffold with receptor-mediated cell attachment sites offers promising possibilities in liver tissue engineering.

Grooves affect primary bone marrow but not osteoblastic MC3T3-E1 cell cultures

To elucidate the influence of microtextures on bone cell performance, primary adult rat bone marrow cells (RBMC) and osteoblastic MC3T3-E1 cells were cultured on tissue culture pretreated plates to which grooves at different density were applied. RBMC cells were found to be significantly affected by grooves in the substratum in contrast to osteoblastic MC3T3-E1 cells, taking culture morphology, total cell number, cell mass, and cell activity (MTT-dehydrogenase), parameter for differentiation of osteoblast progenitor cells into (pre-)osteoblasts (alkalinephosphatase activity, ALP) and tartrate-resistant acid phosphatase (TRAP) activity as indices. TRAP is located in lysosomes and secretory granules mainly although not solely in osteoclasts. By applying grooves to and/or by chemical treatment of unpretreated pure polysterene plates it could be concluded that the effects on RBMC cells were evoked not only by the presence of grooves but also by the surface chemistry of the grooved and ungrooved surface areas.

Pitfalls and solutions in virtual design of nasoalveolar molding plates by using CAD/CAM technology--A preliminary clinical study

PURPOSE

Computer-assisted design and computer-aided manufacturing (CAD/CAM) technology in nasoalveolar molding (NAM) should save time and manpower and reduce family input in cases of cleft lip and palate.

MATERIAL AND METHODS

Intraoral casts from 12 infants with complete unilateral cleft lip and palate were taken immediately after birth (T1) and after (T2) NAM treatment, digitalized, and transformed into STL data. The infants were randomized into Group 1 (n = 6) receiving conventional NAM treatment or Group 2 receiving CAD/CAM NAM (n = 6). We analyzed the following variables by using Geomagic software: intersegmental alveolar distance (ISAD); intersegmental lip distance (ISLD); nostril height cleft/noncleft (NHc/nc); nasal width cleft/noncleft (NWn/nc); and columella deviation angle (CDA).

RESULTS

In both groups, all variables except NHnc and NWnc were changed significantly between T1 and T2. The analysis of the mean differences of the variables in Group 1 and 2 showed no significant differences, with a comparable incidence of clinical alterations such as skin or mucosal irritations.

CONCLUSION

NAM plates can be produced virtually by using CAD/CAM technology. The CAD/CAM NAM results show no significant differences from the conventional technique. We present our clinically usable virtual CAD/CAM workflow for producing a basic NAM plate.

Vascular tissue engineering with magnetic nanoparticles: seeing deeper

The endothelium bares a paramount therapeutic and diagnostic significance in vascular disease. The current work presents a novel strategy based on the use of superparamagnetic nanoparticles to obtain an endothelial cell lining on the luminal surface of vascular conduits, which can be detected non-invasively in a clinical Magnetic Resonance Imaging (MRI) scanner. Human umbilical vein endothelial cells (HUVECs) were prelabeled with clinically approved superparamagnetic nanoparticles. Cell viability and eNOS expression were not affected by the labelling procedure. Magnetically labelled cells were delivered onto the lumen of a PTFE tubular graft by a customised electromagnet. The endothelium was detected in a 1,5T MRI scanner. Magnetic cell delivery provides an efficient technique to seed tubular scaffolds enabling the non-invasive depiction of the cells from the substrate, thus providing a reliable tool to assess the quality of cell delivery procedures.

Titanium dioxide ceramics control the differentiated phenotype of cardiac muscle cells in culture

A new approach, the cultivation of heart muscle cells on biocompatible scaffolds made from titanium dioxide ceramics was established to provide a mechanism for in vitro engineering of a vital heart tissue. Terminally differentiated ventricular myocytes isolated from hearts of adult rats were kept in primary culture for long periods of time and used as an experimental model. The microenvironmental properties of titanium dioxide ceramics helped to maintain the tissue-like structural organisation of the cardiac cells in vitro. Coating of the cell substrata with fine-grained titanium dioxide ceramics imitating cell surface topography favoured the formation of focal adhesion complexes in the ventral plasma membrane of cardiomyocytes. It also promoted the cellular expression of vinculin, a protein that connects the ECM integrin receptors to the network of cytoplasmic filaments, which define cell shape. This topographical reinforcement of cell-material interactions led to stabilisation of the molecular linkage between the extracellular contacts and the intracellular cytoskeleton and thus assisted the preservation and maintenance of the heart muscle cell differentiated phenotype in long-term primary culture. The results of this work demonstrate a promising pathway for the regulation of cellular organisation in vitro by local geometric control.

pH-stabilization of predegraded PDLLA by an admixture of water-soluble sodiumhydrogenphosphate--results of an in vitro- and in vivo-study

Aim of the study was to examine if the addition of buffering sodiumhydrogenphosphate to poly(D,L)lactide(PDLLA) would stabilize the pH-value in the in vivo environment of implanted material and whether this improves its biocompatibility. The material was predegraded just to the point of viscous disintegration to test the PDLLA in the moment of its most aggressive effect on the surrounding tissue. Racemic amorphous PDLLA was injection-molded with or without the admixture of 1 mol NaP per 100 mol lactate, the degradation product of PDLLA (=1 mol%) to form 20mm x 3 mm x 2mm rods. Predegradation was performed by storing the rods at 55 degrees C for 14 days, just to the point of beginning dissolution. Predegraded PDLLA or PDLLA + NaP samples were used for in vitro incubation tests, as well as for the in vivo study, where the rods were implanted into the spinal muscles of 30 male Wistar rats. Repeatedly, measurements of the pH-value were made in the incubation solutions in vitro. The surrounding tissue of the implanted samples as well as the normal contralateral muscle tissue was checked for its pH-value in a group of 3 rats, respectively, anaesthesized at various time intervals after implantation. After these measurements the implants and their surrounding tissues were excised for histological examination. In Ringer's solution pH-values dropped immediately within the first week of incubation of both predegraded materials reaching -4 pH units after 4 weeks in the PDLLA containing medium, after 6 weeks in the PDLLA + NaP containing medium. Soerensen buffer slowed the pH decrease with significant differences between the material groups up to the 28th week. In vivo, the pH of the surrounding tissue was influenced by the implanted PDLLA material up to the 4th week, while the admixture of NaP resulted in a significant pH stabilization. A higher quantity of macrophages and giant cells were seen between the 2nd and 6th week after the implantation in the environment of pure PDLLA compared with PDLLA + NaP. Complete resorption of predegraded pure PDLLA or PDLLA + NaP from the extracellular space was reached 28 weeks postimplantation in vivo. Thus, sodiumhydrogenphosphate improves the biocompatibility of degrading PDLLA at the point of viscous disintegration by stabilizing the pH-value in the environment of the implants for several weeks and reducing adverse tissue reactions.

Supercritical CO2 in injection molding can produce open porous polyurethane scaffolds – a parameter study

There are several methods of producing open porous polymer structures for medical use. However, very few are applicable to industries and are therefore limited to both number of samples and batch variations. This study presents an industrial microcellular injection molding process, known as MuCell® technology, which was used to produce highly porous scaffolds of thermoplastic polyurethane. A parameter study was performed to quantify and analyze the effect of the processing parameters on the porous structure. Six key parameters (gas content, weight reduction, injection speed, mold temperature, plasticizing pressure, and temperature) were tested with an iteration method. The pore structure was determined with advanced micro Computer Tomography algorithm. All key processing parameters were identified. Gas content and weight reduction showed a more profound effect on the pore morphology than other parameters on the pore structure. It was possible to produce scaffolds with open porosity as high as 71%. The study concludes that MuCell® technology is an accurate and liable production method for large-scale production of open porous thermoplastic polyurethane scaffolds, and supercritical fluid could, therefore, be a potential production method for polymer scaffolds.

Autosterilization of biodegradable implants by injection molding process

Sterilization of degradable implants by standard procedures may damage the parts due to the labile chemical nature of the polymers. This study examined whether the injection molding process used for the production of polymeric parts may itself sterilize the implant due to high temperature, pressure, and shear forces applied. Poly-D,L-lactic acid (PDLLA) and poly-L-lactic acid (PLLA) granules were contaminated with thermoresistant spores of Bacillus stearothermophilus (>10(5) spores/g). Sterile and contaminated granules of both polymers were injection molded and tested for sterility. All 27 samples produced with sterile PDLLA and processed at 120 degrees C and all 18 samples produced with sterile PLLA at 200 degrees C remained sterile after injection molding and handling. However, in five out of 28 PDLLA samples and in one out of 26 PLLA samples produced with contaminated material, spores had survived the process. In conclusion, the injection molding process could not reliably sterilize parts produced with polylactic acid granules that were heavily contaminated with thermoresistant organisms. However, the number of viable spores was significantly reduced by more than 99.99%. Thus, the injection molding process might allow the autosterilization of parts produced with raw material that is not heavily contaminated.