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1.
J Reconstr Microsurg ; 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34553344

RESUMO

BACKGROUND: Current near-infrared spectroscopy (NIRS)-based systems for continuous flap monitoring are limited to flaps which carry a cutaneous paddle. As such, this useful and reliable technology has not previously been applicable to muscle-only free flaps where other modalities with substantial limitations continue to be utilized. METHODS: We present the first NIRS probe which allows continuous monitoring of local tissue oxygen saturation (StO2) directly within the substance of muscle tissue. This probe is flexible, subcentimeter in scale, waterproof, biocompatible, and is fitted with resorbable barbs which facilitate temporary autostabilization followed by easy atraumatic removal. This novel device was compared with a ViOptix T.Ox monitor in a porcine rectus abdominus myocutaneous flap model of arterial and venous occlusions. During these experiments, the T.Ox device was affixed to the skin paddle, while the novel probe was within the muscle component of the same flap. RESULTS: The intramuscular NIRS device and skin-mounted ViOptix T.Ox devices produced very similar StO2 tracings throughout the vascular clamping events, with obvious and parallel changes occurring upon vascular clamping and release. The normalized cross-correlation at zero lag describing correspondence between the novel intramuscular NIRS and T.Ox devices was >0.99. CONCLUSION: This novel intramuscular NIRS probe offers continuous monitoring of oxygen saturation within muscle flaps. This experiment demonstrates the potential suitability of this intramuscular NIRS probe for the task of muscle-only free flap monitoring, where NIRS has not previously been applicable. Testing in the clinical environment is necessary to assess durability and reliability.

2.
Nat Commun ; 12(1): 5008, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429436

RESUMO

Capabilities for continuous monitoring of pressures and temperatures at critical skin interfaces can help to guide care strategies that minimize the potential for pressure injuries in hospitalized patients or in individuals confined to the bed. This paper introduces a soft, skin-mountable class of sensor system for this purpose. The design includes a pressure-responsive element based on membrane deflection and a battery-free, wireless mode of operation capable of multi-site measurements at strategic locations across the body. Such devices yield continuous, simultaneous readings of pressure and temperature in a sequential readout scheme from a pair of primary antennas mounted under the bedding and connected to a wireless reader and a multiplexer located at the bedside. Experimental evaluation of the sensor and the complete system includes benchtop measurements and numerical simulations of the key features. Clinical trials involving two hemiplegic patients and a tetraplegic patient demonstrate the feasibility, functionality and long-term stability of this technology in operating hospital settings.


Assuntos
Técnicas Biossensoriais/métodos , Fontes de Energia Elétrica , Pressão , Temperatura , Tecnologia sem Fio , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas Biossensoriais/instrumentação , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Pele , Termografia/instrumentação , Termografia/métodos
3.
Nat Mater ; 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34326506

RESUMO

Flexible electronic/optoelectronic systems that can intimately integrate onto the surfaces of vital organ systems have the potential to offer revolutionary diagnostic and therapeutic capabilities relevant to a wide spectrum of diseases and disorders. The critical interfaces between such technologies and living tissues must provide soft mechanical coupling and efficient optical/electrical/chemical exchange. Here, we introduce a functional adhesive bioelectronic-tissue interface material, in the forms of mechanically compliant, electrically conductive, and optically transparent encapsulating coatings, interfacial layers or supporting matrices. These materials strongly bond both to the surfaces of the devices and to those of different internal organs, with stable adhesion for several days to months, in chemistries that can be tailored to bioresorb at controlled rates. Experimental demonstrations in live animal models include device applications that range from battery-free optoelectronic systems for deep-brain optogenetics and subdermal phototherapy to wireless millimetre-scale pacemakers and flexible multielectrode epicardial arrays. These advances have immediate applicability across nearly all types of bioelectronic/optoelectronic system currently used in animal model studies, and they also have the potential for future treatment of life-threatening diseases and disorders in humans.

4.
Nat Commun ; 11(1): 5990, 2020 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-33239608

RESUMO

Bioresorbable electronic stimulators are of rapidly growing interest as unusual therapeutic platforms, i.e., bioelectronic medicines, for treating disease states, accelerating wound healing processes and eliminating infections. Here, we present advanced materials that support operation in these systems over clinically relevant timeframes, ultimately bioresorbing harmlessly to benign products without residues, to eliminate the need for surgical extraction. Our findings overcome key challenges of bioresorbable electronic devices by realizing lifetimes that match clinical needs. The devices exploit a bioresorbable dynamic covalent polymer that facilitates tight bonding to itself and other surfaces, as a soft, elastic substrate and encapsulation coating for wireless electronic components. We describe the underlying features and chemical design considerations for this polymer, and the biocompatibility of its constituent materials. In devices with optimized, wireless designs, these polymers enable stable, long-lived operation as distal stimulators in a rat model of peripheral nerve injuries, thereby demonstrating the potential of programmable long-term electrical stimulation for maintaining muscle receptivity and enhancing functional recovery.


Assuntos
Implantes Absorvíveis , Terapia por Estimulação Elétrica/instrumentação , Traumatismos dos Nervos Periféricos/terapia , Poliuretanos/química , Tecnologia sem Fio/instrumentação , Animais , Modelos Animais de Doenças , Terapia por Estimulação Elétrica/métodos , Feminino , Humanos , Teste de Materiais , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Ratos , Regeneração , Nervo Isquiático/lesões , Nervo Isquiático/fisiologia
5.
Nat Biomed Eng ; 4(10): 997-1009, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32895515

RESUMO

The rigidity and relatively primitive modes of operation of catheters equipped with sensing or actuation elements impede their conformal contact with soft-tissue surfaces, limit the scope of their uses, lengthen surgical times and increase the need for advanced surgical skills. Here, we report materials, device designs and fabrication approaches for integrating advanced electronic functionality with catheters for minimally invasive forms of cardiac surgery. By using multiphysics modelling, plastic heart models and Langendorff animal and human hearts, we show that soft electronic arrays in multilayer configurations on endocardial balloon catheters can establish conformal contact with curved tissue surfaces, support high-density spatiotemporal mapping of temperature, pressure and electrophysiological parameters and allow for programmable electrical stimulation, radiofrequency ablation and irreversible electroporation. Integrating multimodal and multiplexing capabilities into minimally invasive surgical instruments may improve surgical performance and patient outcomes.


Assuntos
Cateteres Cardíacos , Eletrônica/instrumentação , Monitorização Intraoperatória/instrumentação , Monitorização Intraoperatória/métodos , Animais , Ablação por Cateter , Eletroporação , Desenho de Equipamento , Feminino , Análise de Elementos Finitos , Ventrículos do Coração/cirurgia , Humanos , Pressão , Coelhos , Temperatura
6.
Adv Healthc Mater ; 9(16): e2000942, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32597568

RESUMO

Measurements of regional internal body temperatures can yield important information in the diagnosis of immune response-related anomalies, for precisely managing the effects of hyperthermia and hypothermia therapies and monitoring other transient body processes such as those associated with wound healing. Current approaches rely on permanent implants that require extraction surgeries after the measurements are no longer needed. Emerging classes of bioresorbable sensors eliminate the requirements for extraction, but their use of percutaneous wires for data acquisition leads to risks for infection at the suture site. As an alternative, a battery-free, wireless implantable device is reported here, which is constructed entirely with bioresorbable materials for monitoring regional internal body temperatures over clinically relevant timeframes. Ultimately, these devices disappear completely in the body through natural processes. In vivo demonstrations indicate stable operation as subcutaneous and intracranial implants in rat models for up to 4 days. Potential applications include monitoring of healing cascades associated with surgical wounds, recovery processes following internal injuries, and the progression of thermal therapies for various conditions.


Assuntos
Implantes Absorvíveis , Temperatura Corporal , Animais , Ratos , Temperatura , Tecnologia sem Fio , Cicatrização
7.
Adv Mater ; 31(42): e1902739, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31489737

RESUMO

Transient forms of electronics, systems that disintegrate, dissolve, resorb, or sublime in a controlled manner after a well-defined operating lifetime, are of interest for applications in hardware secure technologies, temporary biomedical implants, "green" consumer devices and other areas that cannot be addressed with conventional approaches. Broad sets of materials now exist for a range of transient electronic components, including transistors, diodes, antennas, sensors, and even batteries. This work reports the first examples of transient light-emitting diodes (LEDs) that can completely dissolve in aqueous solutions to biologically and environmentally benign end products. Thin films of highly textured ZnO and polycrystalline Mo serve as semiconductors for light generation and conductors for transparent electrodes, respectively. The emitted light spans a range of visible wavelengths, where nanomembranes of monocrystalline silicon can serve as transient filters to yield red, green, and blue LEDs. Detailed characterization of the material chemistries and morphologies of the constituent layers, assessments of their performance properties, and studies of their dissolution processes define the underlying aspects. These results establish an electroluminescent light source technology for unique classes of optoelectronic systems that vanish into benign forms when exposed to aqueous conditions in the environment or in living organisms.


Assuntos
Semicondutores , Molibdênio/química , Fenômenos Ópticos , Solubilidade , Água/química , Óxido de Zinco/química
8.
Nat Biomed Eng ; 3(8): 644-654, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31391594

RESUMO

Capabilities in real-time monitoring of internal physiological processes could inform pharmacological drug-delivery schedules, surgical intervention procedures and the management of recovery and rehabilitation. Current methods rely on external imaging techniques or implantable sensors, without the ability to provide continuous information over clinically relevant timescales, and/or with requirements in surgical procedures with associated costs and risks. Here, we describe injectable classes of photonic devices, made entirely of materials that naturally resorb and undergo clearance from the body after a controlled operational lifetime, for the spectroscopic characterization of targeted tissues and biofluids. As an example application, we show that the devices can be used for the continuous monitoring of cerebral temperature, oxygenation and neural activity in freely moving mice. These types of devices should prove useful in fundamental studies of disease pathology, in neuroscience research, in surgical procedures and in monitoring of recovery from injury or illness.


Assuntos
Implantes Absorvíveis , Técnicas Biossensoriais/instrumentação , Óptica e Fotônica/instrumentação , Análise Espectral/métodos , Animais , Materiais Biocompatíveis , Engenharia Biomédica/instrumentação , Análise Química do Sangue/instrumentação , Análise Química do Sangue/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Desenho de Equipamento , Feminino , Camundongos , Modelos Animais , Neurociências , Fibras Ópticas , Silício/química , Temperatura
9.
ACS Nano ; 12(10): 9721-9732, 2018 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-30160102

RESUMO

Foundry-compatible materials and processing approaches serve as the foundations for advanced, active implantable microsystems that can dissolve in biofluids into biocompatible reaction products, with broad potential applications in biomedicine. The results reported here include in vitro studies of the dissolution kinetics and nanoscale bioresorption behaviors of device-grade thin films of Si, SiN x, SiO2, and W in the presence of dynamic cell cultures via atomic force microscopy and X-ray photoemission spectroscopy. In situ investigations of cell-extracellular mechanotransduction induced by cellular traction provide insights into the cytotoxicity of these same materials and of microcomponents formed with them using foundry-compatible processes, indicating potential cytotoxicity elicited by W at concentrations greater than 6 mM. The findings are of central relevance to the biocompatibility of modern Si-based electronics technologies as active, bioresorbable microsystems that interface with living tissues.


Assuntos
Materiais Biocompatíveis/farmacologia , Mecanotransdução Celular/efeitos dos fármacos , Compostos de Silício/farmacologia , Tungstênio/farmacologia , Materiais Biocompatíveis/química , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Humanos , Cinética , Microscopia de Força Atômica/instrumentação , Espectroscopia Fotoeletrônica/instrumentação , Semicondutores , Compostos de Silício/química , Tungstênio/química
10.
Adv Mater ; 30(32): e1801584, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29944186

RESUMO

Optical technologies offer important capabilities in both biological research and clinical care. Recent interest is in implantable devices that provide intimate optical coupling to biological tissues for a finite time period and then undergo full bioresorption into benign products, thereby serving as temporary implants for diagnosis and/or therapy. The results presented here establish a silicon-based, bioresorbable photonic platform that relies on thin filaments of monocrystalline silicon encapsulated by polymers as flexible, transient optical waveguides for accurate light delivery and sensing at targeted sites in biological systems. Comprehensive studies of the mechanical and optical properties associated with bending and unfurling the waveguides from wafer-scale sources of materials establish general guidelines in fabrication and design. Monitoring biochemical species such as glucose and tracking physiological parameters such as oxygen saturation using near-infrared spectroscopic methods demonstrate modes of utility in biomedicine. These concepts provide versatile capabilities in biomedical diagnosis, therapy, deep-tissue imaging, and surgery, and suggest a broad range of opportunities for silicon photonics in bioresorbable technologies.


Assuntos
Técnicas Biossensoriais , Animais , Camundongos , Óptica e Fotônica , Fótons , Polímeros , Silício
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