Polypropylene meshes coated with a polysaccharide based bioadhesive for intra-abdominal mesh fixation in a rabbit model.

BACKGROUND: In this study, we evaluate a new bioadhesive for intra-abdominal onlay mesh fixation of a polypropylene-polyvinylchloride graft. METHODS: Three pieces of a commercially available polypropylene/polyvinylfluoride mesh, each 3 × 3 cm in size, and three pieces of the same mesh coated with a polysaccharide bioadhesive were fixated to the surface of the anterior abdominal wall of 30 New Zealand white rabbits. The fixation was performed either by using four transabdominal Prolene(®) 4/0 sutures, four spiral tacks (Protack 5 mm Tyco), or cyanoacrylate glue (Glubran(®) GEM, Viareggio, Italy). Each mesh position and the according kind of fixation were randomized before implantation. The animals were sacrificed 12 weeks postoperatively. After determining the extent of intra-abdominal adhesions, the meshes were excised en bloc with the anterior abdominal wall for tensile strength measurements and histological analysis. RESULTS: All meshes coated with the bioadhesive adhered to the intact peritoneum without extra fixation. Irrespective of the fixation technique coated meshes led to more and stronger adhesions. Mesh shrinkage by scarring was increased in coated meshes fixed with glue and low in uncoated meshes fixed with tacks. Testing the tensile strength, coated meshes fixed with transfascial sutures achieved the best results (16.14 ± 6.1 N), whereas coated meshes fixed with glue showed the lowest strength (10.39 ± 4.81 N). The foreign body reaction was considerably more distinctive using coated mesh. The mesh ingrowth was not influenced by this reaction. CONCLUSIONS: All meshes coated with the new bioadhesive were self-adhesive in that way; they stayed in position when attached to the peritoneum. Although this may facilitate intra-operative mesh fixation, the bioadhesive displayed several disadvantages, such as stronger adhesions and an increased shrinkage of the implant. The tensile strength was not influenced by the use of the bioadhesive. At present, we see no major advantage for polysaccharide bioadhesive applied in this study.

Overcoming hypoxia in 3D culture systems for tissue engineering of bone in vitro using an automated, oxygen-triggered feedback loop.

Tissue engineering is an attractive approach to heal bony defects. However, three-dimensional cell-scaffold constructs display uneven oxygen supply resulting in inhomogeneous tissue quality. We assessed different strategies to improve oxygen supply in vitro. Scaffolds with differing inner surface were seeded with preosteoblastic cells and cultivated either statically or in perfusion bioreactors. Oxygen concentration and pH were measured in the center of the scaffolds. An inductive feedback mechanism was build to increase bioreactor pump speed according to the oxygen concentrations measured within the scaffolds. While pH remained stable, oxygen concentration decreased significantly under static conditions within the cell-seeded scaffolds. Reducing the scaffolds' inner surface as well as increasing perfusion speeds in bioreactors resulted in improved oxygen supply. We conclude that improving oxygen supply to three dimensional culture systems for bone tissue engineering is feasible in an automated manner. Culture conditions have to be adapted to each cell-scaffold system individually.

Characterisation of a new bioadhesive system based on polysaccharides with the potential to be used as bone glue.

Although gluing bone is in theory a very attractive alternative to classical fracture treatment, this method is not yet clinically established due to the lack of an adhesive which would meet all the necessary requirements. We therefore developed a novel two-component bioadhesive system with the potential to be used as a bone adhesive based on biocompatible and degradable biopolymers (chitosan, oxidised dextran or starch). After mixing in water, the two components covalently cross-link by forming a Schiff's base. By the same mechanism, the glue binds to any other exposed amino group such as for example those exposed in fractured bone, even in the presence of water. Modified chitosan was synthesised from commercially available chitosan by deacetylation and was then reduced in molecular weight by heating in acid. The amount of free amino groups was analysed by IR. The molecular weight was determined by viscosimetry. Starch or dextran were oxidised with periodic acid to generate aldehyde groups, which were quantified by titration. l-Dopa was conjugated to oxidised dextran or starch in analogy to the gluing mechanism of mussels. Biomechanical studies revealed that the new glue is superior to fibrin glue, but has less adhesive strength than cyanoacrylates. In vitro cell testing demonstrated excellent biocompatibility, rendering this glue a potential candidate for clinical use.

Biofunctionalization of dispense-plotted hydroxyapatite scaffolds with peptides: quantification and cellular response.

Hydroxyapatite (HA) ceramic is a widely used synthetic bone substitute material for the regeneration of bone defects. We manufactured HA scaffolds with adjustable pore sizes and pore geometry by dispense-plotting. In addition, we attached peptides covalently onto the HA surface and are able to simultaneously quantify the amount of covalently attached and adsorbed peptide down to the picomolar range with a novel fluorescence-based detection method. In cell culture assays with stromal bone marrow cells, we observed a positive effect of biofunctionalization on cell differentiation after 21 days of culture when comparing the scaffold functionalized with the RGD motif containing adhesion peptide to an unmodified scaffold.

Enzyme-catalysed synthesis of calcium phosphates.

A biomimetic method is described for the precipitation of nanosized calcium phosphates using the alkaline phosphatase (EC 3.1.3.1), which is responsible for hydrolysis of organic and inorganic phosphates in vivo. Buffered solutions containing glycerol-2-phosphate and CaCl(2) in addition to MgCl(2) and the respective enzyme were prepared for calcium phosphate precipitation. The phosphate group of glycerol-2-phosphate was cleaved through enzymatic hydrolysis. The local inorganic phosphate concentration increased resulting in the precipitation of nanosized calcium phosphates phases (Ca-P phase) composed of calcium deficient hydroxyapatite (CDHA) and hydroxyapatite (HA). At high Ca(2+)-concentration and large enzyme amounts mixed phases of HA/CDHA with an increasing quantity of HA were favoured. Under basic conditions (pH > 9) formation of HA was observed, whereas at neutral pH of 7.5 CDHA was primarily formed. The assignment of Ca-P phases was accomplished by FT-IR and Raman-spectroscopy in addition to X-ray diffractometry. The Ca-P materials exhibited BET surface areas of 173 m(2)/g. SEM-micrographs of the Ca-P powders showed globular-shaped agglomerates of Ca-P particles. The size of the Ca-P crystallite ranged from 9 nm to 25 nm according to transmission electron microscopy (TEM), where round-shaped, platelike and fibrelike crystallites were found. All crystallites showed diffuse ring patterns in electron diffraction confirming the nanosize of the precipitate. Using the developed technique, it was possible to synthesise 100 g of bonelike Ca-P materials in 1 day using 15 L batches with optimised parameters.

A novel method for producing electron transparent films of interfaces between cells and biomaterials.

Transmission electron microscopy (TEM) investigations of intact interfaces of cells and brittle biomaterials have proven difficult using common TEM preparation techniques. This paper describes a technique to fabricate thin sections for TEM investigation of intact interfaces between human monocytes and sintered hydroxylapatite by the use of focused ion beam (FIB) microscopy. The interfaces were examined using energy filtered TEM.

Cell type-specific aspects in biocompatibility testing: the intercellular contact in vitro as an indicator for endothelial cell compatibility.

Endothelial cells cover the inner surface of blood vessels and form the interface between the blood and the tissues. Endothelial cells are involved in regulating barrier function, which is maintained by the interendothelial cell contacts. These interendothelial cell contacts are established by the interaction of different molecules. The maintenance of the barrier requires an appropriate signalling between these molecules. Thus, a number of different signalling pathways are integrated within interendothelial contacts. Since endothelial cells are important in tissue-implant interactions (especially for stent materials) this study examines the expression pattern of different interendothelial contact molecules to determine the usefulness in the analysis of biocompatibility in vitro. The effects of different pro-inflammatory and toxic stimuli and contact of human microvascular endothelial cells to metallic surfaces were examined for their impact on the pattern of interendothelial contact molecules. Striking modifications in the arrangement of these molecules were induced and the mode of modification was dependent on the tested compound. Thus, examining the pattern of expression of specific interendothelial contact molecules in vitro may be useful for testing the endothelial cell compatibility of biomaterials and their corrosion products.

Effect of surface modification of polymer beads on the mechanical properties of acrylic bone cement.

The effect of surface modification of polymer filler on the static mechanical properties of acrylic bone cement was studied. The surface of polymer beads was modified with carboxylic and amino groups by photochemical reaction with azide compounds. Monomer modifiers (maleic anhydride, methacrylic acid and p-aminostyrene) are attached to the functionalized surface of polymer beads. Functional allyl groups, which are capable of the graft polymerisation reaction, are attached to the surface via photochemical reaction with N-(2-nitro-4-azidophenyl)-N-(-propen) amine. This approach to bone cement provides the additional covalent bonds between the polymer beads and the inter-bead matrix. The static mechanical properties of bone cements containing modified polymer beads were investigated and compared with the static mechanical properties of unmodified cements. The absolute values of compressive strength for the modified and unmodified cements were found to be similar. An increase in flexural strength for the modified cements (dry and after water storage) was observed. The structure of the surface functional groups affects the methyl methacrylate grafting resulting in a higher value of flexural strength for the maleic anhydride- and p-aminostyrene-modified cements. The scanning electron microscopy examination of the fracture surface of the cement samples showed an improvement of the adhesion between the beads and the matrix after modification.

In situ SEM imaging at temperatures as high as 1450 degrees C.

Modifications to a scanning electron microscope (SEM) and a commercially available heating stage permits in situ imaging at temperatures as high as 1450 degrees C. Here we report on the technical modifications necessary to allow such high-temperature in situ imaging. In addition, in order to underline the potential of this technique in the field of materials science, three heating-stage experiments are presented, which reveal microstructural changes occurring at high temperature. The respective in situ experiments are: (i) surface crystallization of a cordierite glass at 1050 degrees C; (ii) thermal recovery of asbestos (chrysotile) fibers at 1250 degrees C; and (iii) residual pore-structure evolution of tricalcium phosphate during sintering at 1450 degrees C.