Stapled fascial suture: ex vivo modeling and clinical implications.

BACKGROUND: Recently, in the field of abdominal wall repair surgery, some minimally invasive procedures introduced the use of staplers to provide a retromuscular prosthetic repair. However, to the knowledge of the authors, there are little data in the literature about the outcomes of stapled sutures adoption for midline reconstruction. This study aims to investigate the biomechanics of stapled sutures, simple (stapled), or oversewn (hybrid), in comparison with handsewn suture. From the results obtained, we tried to draw indications for their use in a clinical context. METHODS: Human cadaver fascia lata specimens, sutured (handsewn, stapled, or hybrid) or not, underwent tensile tests. The data on strength (maximal stress), ultimate strain (deformability), Young's modulus (rigidity), and dissipated specific energy (ability to absorb mechanical energy up to the breaking point) were recorded for each type of specimens and analyzed. RESULTS: Stapled and hybrid suture showed a significantly higher strength (handsewn 0.83 MPa, stapled 2.10 MPa, hybrid 2.68 MPa) and a trend toward a lower ultimate strain as compared to manual sutures (handsewn 344%, stapled 249%, hybrid 280%). Stapled and hybrid sutures had fourfold higher Young's modulus as compared to handsewn sutures (handsewn 1.779 MPa, stapled 7.374 MPa, hybrid 6.964 MPa). Handsewn and hybrid sutures showed significantly higher dissipated specific energy (handsewn 0.99 mJ-mm3, stapled 0.73 mJ-mm3, hybrid 1.35 mJ-mm3). CONCLUSION: Stapled sutures can resist high loads, but are less deformable and rigid than handsewn suture. This suggests a safer employment in case of small defects or diastasis (< W1 in accord to EHS classification), where the presumed tissutal displacement is minimal. Oversewing a stapled suture improves its efficiency, becoming crucial in case of larger defects (> W1 in accord to EHS classification) where the expected tissutal displacement is maximal. Hybrid sutures seem to be a good compromise.

Tidy dataset of the experimental design of the optimization of the alkali degumming process of Bombyx mori silk.

Silk fibroin is the structural fiber of the silk filament and it is usually separated from the external protein, named sericine, by a chemical process called degumming. This process consists of an alkali bath in which the silk cocoons are boiled for a determined time. It is also known that the degumming process impacts the property of the outcoming silk fibroin fibers. In this work, we described the dataset obtained from a Design of Experiment (DoE) screening made on the alkali degumming. Four process factors were considered: the number of degumming baths, the process time, the process temperature, and the salt concentration. The data on the properties of the silk fibroin fibers were collected. In particular, the molecular weight was obtained by gel permeation chromatography (GPC), the mechanical data by tensile test and the secondary structure by Fourier Infrared Transform Spectroscopy (FTIR).

Photon emission and changes in fluorescent properties of bone after laser irradiation.

Laser scalpels used in medical surgery concentrate light energy, heating the tissues. Recently, we reported thermoluminescence emission from laser-treated soft tissues. Here we investigated the thermo-optical effects caused by a laser operating at 808 nm on animal bones (beef ribs) through luminescence and fluorescence imaging, thermal imaging and scanning electron microscopy. Laser-induced artificial lesions emitted luminescence peaking around 650 nm, with a half-life of almost 1 hour. As concerns fluorescence, 24 hours after laser treatment we observed an increase of the emission and a shift from 500 (untreated) to 580 nm (treated). Recrystallization observed by SEM indicates that the temperature in the artificial lesions is over 600°C. We can conclude that laser treatment induces specific luminescent and fluorescent emissions due to heating of the bone and modification of its components. Monitoring these emissions could help prevent tissue overheating and its potential damages during laser-assisted medical procedures.

A Design of Experiment Rational Optimization of the Degumming Process and Its Impact on the Silk Fibroin Properties.

Silk fibroin is a protein with a unique combination of properties and is widely studied for biomedical applications. The extraction of fibroin (degumming) from the silk filament impacts the properties of the outcoming material. The degumming can be conducted with different procedures. Among them, the most used and studied procedure in the research field is the alkali degumming with sodium carbonate (Na2CO3). In this study, by the use of a statistical method, namely, design of experiment (DOE), we characterized the Na2CO3 degumming, taking into consideration the main process factors involved and changing them within a selected range of values. We considered the process temperature and time, the salt concentration, and the number of baths used, testing the impact of these variables on the fibroin properties by building empirical models. These models not only took into consideration the direct effect of the process factors but also their combined effect, which are not conventionally detectable with other methods. The weight loss and the amount of sericin removed in the process were determined and used as a measure of the effectiveness of the process. The secondary structure, the molecular weight, the diameter of fibers, and their morphology and mechanical properties were studied with the intent to correlate the macroscopical properties with the structural changes. We report, for the first time, the possibility to effectively remove all sericin from the silk fibroin using Na2CO3, using a process that requires less salt, water, and energy, in comparison with the standard alkali protocol, making this technique overall more environmentally sustainable; in addition, we have demonstrated the possibility to tune the material properties by varying the degumming conditions and even to optimize them with empirical statistically based equations that allow one to directly set the optimal process parameters. The major effect on the macroscopical properties (such as the ultimate strength and Young's modulus) has been proved to be correlated with the removal of sericin instead of the microstructural variations. Finally, a ready-to-use table with a set of optimized degumming procedures to maximize or minimize the studied properties was provided.

Injectable Scaffold-Systems for the Regeneration of Spinal Cord: Advances of the Past Decade.

Nowadays, whenever is possible and as an alternative to open spine surgery, minimally invasive procedures are preferred to treat spinal cord injuries (SCI), with percutaneous injections or small incisions, that are faster, less traumatic, and require less recovery time. Injectable repair systems are based on materials that can be injected in the lesion site, can eventually be loaded with drugs or even cells, and act as scaffolds for the lesion repair. The review analyzes papers written from 2010 onward on injectable materials/systems used/proposed for the regenerative and combinatorial therapies of SCI and discusses the in vivo models that have been used to validate them.

Disordered protein-graphene oxide co-assembly and supramolecular biofabrication of functional fluidic devices.

Supramolecular chemistry offers an exciting opportunity to assemble materials with molecular precision. However, there remains an unmet need to turn molecular self-assembly into functional materials and devices. Harnessing the inherent properties of both disordered proteins and graphene oxide (GO), we report a disordered protein-GO co-assembling system that through a diffusion-reaction process and disorder-to-order transitions generates hierarchically organized materials that exhibit high stability and access to non-equilibrium on demand. We use experimental approaches and molecular dynamics simulations to describe the underlying molecular mechanism of formation and establish key rules for its design and regulation. Through rapid prototyping techniques, we demonstrate the system's capacity to be controlled with spatio-temporal precision into well-defined capillary-like fluidic microstructures with a high level of biocompatibility and, importantly, the capacity to withstand flow. Our study presents an innovative approach to transform rational supramolecular design into functional engineering with potential widespread use in microfluidic systems and organ-on-a-chip platforms.

Shear-Induced Encapsulation into Red Blood Cells: A New Microfluidic Approach to Drug Delivery.

Encapsulating molecules into red blood cells (RBCs) is a challenging topic for drug delivery in clinical practice, allowing to prolong the residence time in the body and to avoid toxic residuals. Fluidic shear stress is able to temporary open the membrane pores of RBCs, thus allowing for the diffusion of a drug in solution with the cells. In this paper, both a computational and an experimental approach were used to investigate the mechanism of shear-induced encapsulation in a microchannel. By means of a computational fluid dynamic model of a cell suspension, it was possible to calculate an encapsulation index that accounts for the effective shear acting on the cells, their distribution in the cross section of the microchannel and their velocity. The computational model was then validated with micro-PIV measurements on a RBCs suspension. Finally, experimental tests with a microfluidic channel showed that, by choosing the proper concentration and fluid flow rate, it is possible to successfully encapsulate a test molecule (FITC-Dextran, 40 kDa) into human RBCs. Cytofluorimetric analysis and confocal microscopy were used to assess the RBCs physiological shape preservation and confirm the presence of fluorescent molecules inside the cells.

Weak biophoton emission after laser surgery application in soft tissues: Analysis of the optical features.

Nowadays, laser scalpels are commonly used in surgery, replacing the traditional surgical scalpels for several applications involving cutting or ablating living biological tissue. Laser scalpels are generally used to concentrate light energy in a very small-sized area; light energy is then converted in heat by the tissues. In other cases, the fiber glass tip of the laser scalpel is heated to high temperature and used to cut the tissues. Depending on the temperature reached in the irradiated area, different effects are visible in the tissues. In this study, we report the discovery and characterization of the light emitted by soft mammalian biological tissues from seconds to hours after laser surgery application. A laser diode (with hot fiber glass tip) working at 808 nm and commercially available for medical and dentistry applications was used. The irradiated tissues (red meat, chicken breast and fat) showed light emission in the visible range, well detectable with a commercial charge coupled device (CCD) camera. The time decay of the light emission, the laser power effects and the spectral features in the range 500 to 840 nm in the different tissues are here reported.