加强心脏手术后胸骨伤口愈合的生物工程方法和新型生物材料:创新与外科实践之间的串联。

IF 5 3区 医学 Q1 ENGINEERING, BIOMEDICAL Journal of Functional Biomaterials Pub Date : 2024-08-31 DOI:10.3390/jfb15090254
Chiara Ferrisi, Francesco Loreni, Antonio Nenna, Omar Giacinto, Mario Lusini, Massimo Chello
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引用次数: 0

摘要

胸骨正中切开术和胸骨钢丝闭合术是心脏手术的标准方法。与胸壁运动相关的不完全修复,尤其是在存在易感因素的情况下,在 2% 到 5% 的病例中会导致危及生命的胸骨深部伤口感染,也称为纵隔炎。尽管目前有抗生素和手术治疗方法,纵隔炎的死亡率仍高达 10-40%,发病率和住院时间也显著增加。高死亡率和治疗困难似乎是由于细菌生物膜造成的,生物膜是一种自身产生的胞外高分子产物,它结合了宿主组织,是免疫防御系统和标准抗菌疗法失效的原因。纳米结构可为细胞外基质的新合成创造有利环境,支持组织发育,因此是促进愈合过程的有效策略。合成聚合物已被证明具有合适的生物可降解性和机械性能,目前正在对其生物功能化进行广泛研究,以增强细胞附着和与细胞外基质的相互作用。将抗生素处理悬浮在聚 D,L-内酰胺和聚氧化乙烯中,然后电纺成纳米纤维或海绵,已证明可抑制细菌生物膜的产生。此外,三维生物可吸收支架中还可加入生长因子,以形成结构和生物框架,组织和加速愈合过程。因此,在不久的将来,这些综合方法可能会改变纵隔炎的治疗方法。
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Bioengineering Approaches and Novel Biomaterials to Enhance Sternal Wound Healing after Cardiac Surgery: A Crosstalk between Innovation and Surgical Practice.

Median sternotomy and steel wires for sternal closure are the standard approach for cardiac surgery. An incomplete repair associated with chest wall motion, especially in the presence of predisposing factors, can lead to life-threatening deep sternal wound infection, also known as mediastinitis, in 2-5% of cases. Despite current antibiotic and surgical treatments, mediastinitis is associated with a 10-40% mortality rate and a significant increase in morbidity and hospital stay. High mortality and difficult treatment appear to be due to bacterial biofilm, a self-produced extracellular polymeric product that incorporates host tissue and is responsible for the failure of immune defenses and standard antimicrobial therapies. Nanostructures are an effective strategy to enhance the healing process, as they establish a favorable environment for the neosynthesis of the extracellular matrix, supporting tissue development. Synthetic polymers have been proven to exhibit suitable biodegradable and mechanical properties, and their biofunctionalization to enhance cell attachment and interaction with the extracellular matrix is being widely investigated. The use of antibiotic treatments suspended in poly-D,L-lactide and polyethylene oxide and electrospun into nanofibers, or in sponges, has been shown to inhibit bacterial biofilm production. Additionally, growth factors can be incorporated into 3D bioresorbable scaffolds with the aim of constituting a structural and biological framework to organize and expedite the healing process. Therefore, these combined approaches may change the treatment of mediastinitis in the near future.

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来源期刊
Journal of Functional Biomaterials
Journal of Functional Biomaterials Engineering-Biomedical Engineering
CiteScore
4.60
自引率
4.20%
发文量
226
审稿时长
11 weeks
期刊介绍: Journal of Functional Biomaterials (JFB, ISSN 2079-4983) is an international and interdisciplinary scientific journal that publishes regular research papers (articles), reviews and short communications about applications of materials for biomedical use. JFB covers subjects from chemistry, pharmacy, biology, physics over to engineering. The journal focuses on the preparation, performance and use of functional biomaterials in biomedical devices and their behaviour in physiological environments. Our aim is to encourage scientists to publish their results in as much detail as possible. Therefore, there is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Several topical special issues will be published. Scope: adhesion, adsorption, biocompatibility, biohybrid materials, bio-inert materials, biomaterials, biomedical devices, biomimetic materials, bone repair, cardiovascular devices, ceramics, composite materials, dental implants, dental materials, drug delivery systems, functional biopolymers, glasses, hyper branched polymers, molecularly imprinted polymers (MIPs), nanomedicine, nanoparticles, nanotechnology, natural materials, self-assembly smart materials, stimuli responsive materials, surface modification, tissue devices, tissue engineering, tissue-derived materials, urological devices.
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