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Heitzer M, Kilic K, Merfort R, Winnand P, Emonts C, Bock A, Ooms M, Steiner T, Hölzle F, Modabber A. Tensile strength of adhesives in peripheral nerve anastomoses: an in vitro biomechanical evaluation of four different neurorrhaphies. Eur J Med Res 2024; 29:264. [PMID: 38698476 PMCID: PMC11067280 DOI: 10.1186/s40001-024-01858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The fundamental prerequisite for prognostically favorable postoperative results of peripheral nerve repair is stable neurorrhaphy without interruption and gap formation. METHODS This study evaluates 60 neurorrhaphies on femoral chicken nerves in terms of the procedure and the biomechanical properties. Sutured neurorrhaphies (n = 15) served as control and three sutureless adhesive-based nerve repair techniques: Fibrin glue (n = 15), Histoacryl glue (n = 15), and the novel polyurethane adhesive VIVO (n = 15). Tensile and elongation tests of neurorrhaphies were performed on a tensile testing machine at a displacement rate of 20 mm/min until failure. The maximum tensile force and elongation were recorded. RESULTS All adhesive-based neurorrhaphies were significant faster in preparation compared to sutured anastomoses (p < 0.001). Neurorrhaphies by sutured (102.8 [cN]; p < 0.001), Histoacryl (91.5 [cN]; p < 0.001) and VIVO (45.47 [cN]; p < 0.05) withstood significant higher longitudinal tensile forces compared to fibrin glue (10.55 [cN]). VIVO, with △L/L0 of 6.96 [%], showed significantly higher elongation (p < 0.001) compared to neurorrhaphy using fibrin glue. CONCLUSION Within the limitations of an in vitro study the adhesive-based neurorrhaphy technique with VIVO and Histoacryl have the biomechanical potential to offer alternatives to sutured neuroanastomosis because of their stability, and faster handling. Further in vivo studies are required to evaluate functional outcomes and confirm safety.
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Affiliation(s)
- Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany.
| | - Konrad Kilic
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Ricarda Merfort
- Department of Orthopedics, Trauma and Reconstructive Surgery, University Hospital of RWTH Aachen, Aachen, Germany
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Caroline Emonts
- Institute of Textile Technology, RWTH Aachen University, Otto-Blumenthal-Straße 1, 52074, Aachen, Germany
| | - Anna Bock
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Mark Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Timm Steiner
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of RWTH Aachen, Pauwelsstraße 13, 52074, Aachen, Germany
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Mayrhofer-Schmid M, Aman M, Panayi AC, Raasveld FV, Kneser U, Eberlin KR, Harhaus L, Böcker A. Fibrin Glue Coating Limits Scar Tissue Formation around Peripheral Nerves. Int J Mol Sci 2024; 25:3687. [PMID: 38612497 PMCID: PMC11011750 DOI: 10.3390/ijms25073687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Scar tissue formation presents a significant barrier to peripheral nerve recovery in clinical practice. While different experimental methods have been described, there is no clinically available gold standard for its prevention. This study aims to determine the potential of fibrin glue (FG) to limit scarring around peripheral nerves. Thirty rats were divided into three groups: glutaraldehyde-induced sciatic nerve injury treated with FG (GA + FG), sciatic nerve injury with no treatment (GA), and no sciatic nerve injury (Sham). Neural regeneration was assessed with weekly measurements of the visual static sciatic index as a parameter for sciatic nerve function across a 12-week period. After 12 weeks, qualitative and quantitative histological analysis of scar tissue formation was performed. Furthermore, histomorphometric analysis and wet muscle weight analysis were performed after the postoperative observation period. The GA + FG group showed a faster functional recovery (6 versus 9 weeks) compared to the GA group. The FG-treated group showed significantly lower perineural scar tissue formation and significantly higher fiber density, myelin thickness, axon thickness, and myelinated fiber thickness than the GA group. A significantly higher wet muscle weight ratio of the tibialis anterior muscle was found in the GA + FG group compared to the GA group. Our results suggest that applying FG to injured nerves is a promising scar tissue prevention strategy associated with improved regeneration both at the microscopic and at the functional level. Our results can serve as a platform for innovation in the field of perineural regeneration with immense clinical potential.
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Affiliation(s)
- Maximilian Mayrhofer-Schmid
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
- Hand and Arm Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Martin Aman
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Adriana C. Panayi
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Floris V. Raasveld
- Hand and Arm Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Erasmus University, 3015 GD Rotterdam, The Netherlands
| | - Ulrich Kneser
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Kyle R. Eberlin
- Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Leila Harhaus
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
- Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen, Germany
| | - Arne Böcker
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69120 Heidelberg, Germany
- Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen, Germany
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Fukuda A, Hashimoto M, Takegawa Y, Kondo N, Hasegawa S. Investigation of the appropriate viscosity of fibrinogen in repairing pleural defects using ventilation and anchoring in an ex vivo pig model. J Cardiothorac Surg 2024; 19:149. [PMID: 38515189 PMCID: PMC10956239 DOI: 10.1186/s13019-024-02643-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Our previous study revealed that the viscosity of fibrinogen could influence the effectiveness of ventilation and anchoring (V/A) methods for controlling air leakages. Here, we examined the association between the viscosity of fibrinogen and effectiveness using an ex vivo pig model. METHODS The fibrin glue used in this study was BOLHEAL® (KM Biologics Co., Ltd., Kumamoto, Japan). We prepared three types of fibrinogen with different viscosities (higher and lower than normal), including one without additives. Using an ex vivo pig model, a pleural defect was made, and the defect was repaired using three different viscosities of fibrinogen through the V/A method. We measured the rupture pressure at the repair site (N = 10) and histologically evaluated the depth of fibrin infiltration into the lung parenchyma at the repair sites. RESULTS The median rupture pressure was 51.5 (40-73) cmH2O in Group 1 (lower viscosity), 47.0 (47-88) cmH2O in Group 2 (no change in viscosity), and 35.5 (25-61) cmH2O in Group 3 (higher viscosity). There was no statistically significant difference between Groups 1 and 2 (p = 0.819), but the rupture pressure was significantly higher in Group 2 than in Group 3 (p = 0.0136). Histological evaluation revealed deep infiltration of fibrin into the lung parenchyma in Groups 1 and 2, but no such infiltration was observed in the higher-viscosity group. CONCLUSIONS The results of this experiment suggested that the V/A method using fibrin glue containing low-viscosity fibrinogen was more effective in controlling air leakage due to pleural defects.
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Affiliation(s)
- Akihiro Fukuda
- Department of Thoracic Surgery, School of Medicine, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya city, 6638501, Hyogo, Japan
| | - Masaki Hashimoto
- Department of Thoracic Surgery, School of Medicine, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya city, 6638501, Hyogo, Japan.
| | | | - Nobuyuki Kondo
- Department of Thoracic Surgery, School of Medicine, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya city, 6638501, Hyogo, Japan
| | - Seiki Hasegawa
- Department of Thoracic Surgery, School of Medicine, Hyogo Medical University, Mukogawa-cho 1-1, Nishinomiya city, 6638501, Hyogo, Japan
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Kadam AR, Prabu VR, Reddy JK, Muralidhar V, Thulasidas M. Conjunctiva in strabismus surgery - to stitch or to stick? - A randomized clinical trial. Indian J Ophthalmol 2024; 72:223-227. [PMID: 38099382 PMCID: PMC10941947 DOI: 10.4103/ijo.ijo_543_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/22/2023] [Accepted: 08/11/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To evaluate the clinical outcomes with fibrin glue in comparison with vicryl sutures for limbal conjunctival wound closure in strabismus surgery. METHODS In this prospective interventional study, patients undergoing horizontal muscle strabismus surgery were randomized into two groups: the vicryl suture group and the fibrin glue group. The limbal conjunctival incisions were closed with 8-0 vicryl in the suture group and with fibrin glue in the other group. The outcomes measured were post-operative conjunctival inflammation and wound apposition, patient comfort with the help of a questionnaire, and conjunctival thickness using anterior segment optical coherence tomography (AS-OCT) for both groups at 6 weeks. RESULTS The study included 64 eyes of 64 patients (32 eyes in each group). The fibrin glue group performed better than the vicryl suture group for most of the symptoms like redness, irritation, watering, and foreign body sensation till 2 weeks post-operatively ( P < 0.001), after which both the groups performed similarly. As for clinical signs, no significant difference was noted between the two groups, except for conjunctival hyperemia, which was significantly lesser in the fibrin glue group at 2 weeks post-operatively ( P < 0.001). The conjunctival thickness measured at 6 weeks using AS-OCT revealed that the thickness increased significantly in the suture group compared to that in the glue group ( P < 0.001 medial site, P = 0.004 lateral site). CONCLUSION Because of greater patient comfort and reduced inflammation associated with fibrin glue, it may be considered as a procedure of choice for conjunctival wound closure in strabismus surgery in the absence of the cost constraints.
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Affiliation(s)
- Aishwarya R Kadam
- Department of Ophthalmology, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - V Rajesh Prabu
- Department of Pediatric Ophthalmology and Strabismology, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - Jagadeesh K Reddy
- Department of Cornea and Refractive Sevices, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - Venu Muralidhar
- Consultant Pediatric Ophthalmology Strabismus and Cataract, Gomabai Netralaya, Neemuch, Madhya Pradesh, India
| | - Mithun Thulasidas
- Department of Cataract and Glaucoma Services, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
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Qiao Z, Wang F, Han D, Zhuang Y, Jiang Q, Zhang Y, Liu M, An Q, Wang Z, Shen D. Ultrasound-guided periadventitial administration of rapamycin-fibrin glue attenuates neointimal hyperplasia in the rat carotid artery injury model. Eur J Pharm Sci 2024; 192:106610. [PMID: 37852309 DOI: 10.1016/j.ejps.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/01/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Arterial restenosis caused by intimal hyperplasia (IH) is a serious complication after vascular interventions. In the rat carotid balloon injury model, we injected phosphate buffer saline (PBS), rapamycin-phosphate buffer saline suspension (RPM-PBS), blank fibrin glue (FG) and rapamycin-fibrin glue (RPM-FG) around the injured carotid artery under ultrasound guidance and observed the inhibitory effect on IH. METHODS The properties of RPM-FG in vitro were verified by scanning electron microscopy (SEM) and determination of the drug release rate. FG metabolism in vivo was observed by fluorescence imaging. The rat carotid balloon injury models were randomly classified into 4 groups: PBS group (control group), RPM-PBS group, FG group, and RPM-FG group. Periadventitial administration was performed by ultrasound-guided percutaneous puncture on the first day after angioplasty. Carotid artery specimens were analyzed by immunostaining, Evans blue staining and hematoxylin-eosin staining. RESULTS The RPM particles showed clustered distributions in the FG block. The glue was maintained for a longer time in vivo (> 14 days) than in vitro (approximately 7 days). Two-component liquid FG administered by ultrasound-guided injection completely encapsulated the injured artery before coagulation. The RPM-FG inhibited IH after carotid angioplasty vs. control and other groups. The proliferation of vascular smooth muscle cells (VSMCs) was significantly inhibited during neointima formation, whereas endothelial cell (EC) repair was not affected. CONCLUSION Periadventitial delivery of RPM-FG contributed to inhibiting IH in the rat carotid artery injury model without compromising re-endothelialization. Additionally, FG provided a promising platform for the future development of a safe, effective, and minimally invasive perivascular drug delivery method to treat vascular disease.
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Affiliation(s)
- Zhentao Qiao
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, China
| | - Fuhang Wang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Dongjian Han
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Yuansong Zhuang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Qingjiao Jiang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Yi Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Miaomiao Liu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Quanxu An
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
| | - Zhiwei Wang
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, China
| | - Deliang Shen
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China.
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Liu CH, Chang CH, Chang YH, Shih HN, Hu CC. Topical Fibrin Sealant (Tisseel@) Does Not Provide a Synergic Blood-Conservation Effect with Tranexamic Acid in Total Knee Arthroplasty-A Prospective Randomized Controlled Trial. Medicina (Kaunas) 2023; 59:2078. [PMID: 38138181 PMCID: PMC10744547 DOI: 10.3390/medicina59122078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The efficacy of tranexamic acid (TXA) in reducing perioperative blood loss during total knee arthroplasty (TKA) is well established. However, the potential synergistic blood-conservation effect of topical fibrin sealant (Tisseel@) remains unclear. This study aims to assess the effectiveness of the combination of Tisseel and TXA during TKA. Materials and Methods: A single-blinded, prospective, randomized controlled trial was conducted with 100 patients (100 knees) undergoing primary TKA. Participants were randomly assigned to either the TXA group (n = 50), receiving intravenous (IV) TXA, or the Tisseel@ + TXA group (n = 50), receiving intra-articular Tisseel@ combined with IV TXA. The primary outcomes included blood transfusion rate, decrease in Hb level, calculated blood loss, and estimated total postoperative blood loss. Secondary outcomes involved assessing clinical differences between the groups. Results: The transfusion rate was zero in both groups. The average estimated blood loss in the Tisseel@ + TXA group was 0.463 ± 0.2422 L, which was similar to that of the TXA group at 0.455 ± 0.2522 L. The total calculated blood loss in the Tisseel@ + TXA group was 0.259 ± 0.1 L, compared with the TXA group's 0.268 ± 0.108 L. The mean hemoglobin reduction in the first 24 h postoperatively was 1.57 ± 0.83 g/dL for the Tisseel@ + TXA group and 1.46 ± 0.82 g/dL for the TXA-only group. The reduction in blood loss in the topical Tisseel@ + TXA group was not significantly different from that achieved in the TXA-only group. The clinical results of TKA up to the 6-week follow-up were comparable between the groups. Conclusions: The combination of the topical fibrin sealant Tisseel@ and perioperative IV TXA administration, following the described protocol, demonstrated no significant synergistic blood-conservation effect in patients undergoing TKR.
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Affiliation(s)
- Chia-Hung Liu
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
| | - Chih-Hsiang Chang
- Division of Joint Reconstruction, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-H.C.); (Y.-H.C.); (H.-N.S.)
| | - Yu-Han Chang
- Division of Joint Reconstruction, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-H.C.); (Y.-H.C.); (H.-N.S.)
| | - Hsin-Nung Shih
- Division of Joint Reconstruction, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-H.C.); (Y.-H.C.); (H.-N.S.)
| | - Chih-Chien Hu
- Division of Joint Reconstruction, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (C.-H.C.); (Y.-H.C.); (H.-N.S.)
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Gao W, Bao J, Zhang Y, He D, Zhang L, Zhang J, Pan H, Wang D. Injectable kaempferol-loaded fibrin glue regulates the metabolic balance and inhibits inflammation in intervertebral disc degeneration. Sci Rep 2023; 13:20001. [PMID: 37968507 PMCID: PMC10651831 DOI: 10.1038/s41598-023-47375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/13/2023] [Indexed: 11/17/2023] Open
Abstract
To construct an injectable fibrin glue system loaded with kaempferol (FG@F) to improve the bioavailability of kaempferol and observe its efficacy in the treatment of intervertebral disc degeneration (IVDD). Kaempferol-loaded fibrin glue was first synthesized in advance. Subsequently, the materials were characterized by various experimental methods. Then, nucleus pulposus cells (NPCs) were stimulated with lipopolysaccharide (LPS) to establish a degenerative cell model, and the corresponding intervention treatment was conducted to observe the effect in vitro. Finally, the tail disc of rats was punctured to establish a model of IVDD, and the therapeutic effect of the material in vivo was observed after intervertebral disc injection. The FG@F system has good injectability, sustained release and biocompatibility. This treatment reduced the inflammatory response associated with IVDD and regulated matrix synthesis and degradation. Animal experimental results showed that the FG@F system can effectively improve needle puncture-induced IVDD in rats. The FG@F system has better efficacy than kaempferol or FG alone due to its slow release and mechanical properties. The drug delivery and biotherapy platform based on this functional system might also serve as an alternative therapy for IVDD.
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Affiliation(s)
- Wenshuo Gao
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, People's Republic of China
| | - Jianhang Bao
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China
- Department of Orthopaedics, Yiwu Central Hospital, Yiwu, 322000, Zhejiang, People's Republic of China
| | - Yujun Zhang
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Du He
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Liangping Zhang
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Jun Zhang
- Department of General Surgery, Institute of Orthopaedics and Traumatology, Hangzhou Dingqiao Hospital, Huanding Road NO 1630, Hangzhou, 310021, Zhejiang, People's Republic of China
| | - Hao Pan
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China.
- Department of Orthopaedics, Hangzhou Dingqiao Hospital, Huanding Road NO 1630, Hangzhou, 310021, Zhejiang, People's Republic of China.
- Institute of Orthopaedics and Traumatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Road NO 453, Hangzhou, 310007, Zhejiang, People's Republic of China.
| | - Dong Wang
- Department of Orthopaedics, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, 310000, Zhejiang, People's Republic of China.
- Department of Orthopaedics, Hangzhou Dingqiao Hospital, Huanding Road NO 1630, Hangzhou, 310021, Zhejiang, People's Republic of China.
- Institute of Orthopaedics and Traumatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Road NO 453, Hangzhou, 310007, Zhejiang, People's Republic of China.
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Ural P, Albayrak HK, Gürcan O, Kazanci A, Gürçay AG, Özateş MÖ. Histopathological Study of the Effects of Dura Adhesive Agents Used in Spinal Surgery Practice on Spinal Epidural Fibrosis in Experimental Animal Model. Neurol India 2023; 71:1177-1182. [PMID: 38174454 DOI: 10.4103/0028-3886.391384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Objective Histopathological examination of the effects of Tisseel, Cova, Glubran and Coseal, which are used for sealing purposes in spinal surgery practice, on epidural fibrosis is aimed. Methods Forty Sprague Dawley rats were randomly divided into five groups in our study as Group 1 (n=8) control group (Laminectomy); Group 2 (n=8) Cova group (Laminectomy + Cova); Group 3 (n=8) Tissel group (Laminectomy + Tisseel); Group 4 (n=8) Coseal group (Laminectomy + Coseal); and Group 5 Glubrane group (Laminectomy + Glubrane). Control group was only applied laminectomy. After laminectomy to other groups, Cova was applied to the 2nd group, Tissel to the 3rd group, Coseal to the 4th group and Glubran to the 5th group in surgical fields. After the rats were monitored in separate cages for 6 weeks after the operation, the relevant spinal level was extracted and the samples were examined histopathologically and the results were evaluated statistically. Results It was found that there was a statistically significant difference in Tisseel and Glubran groups in terms of fibrosis grading compared to the control group, and this had a positive effect on fibrosis. Compared to the control group, there was no statistically significant difference on fibrosis in Cova and Coseal groups. Conclusion As dura adhesive agents used in spinal surgery practice did not increase spinal epidural fibrosis statistically significantly, we concluded that these products can be used safely during spinal surgery if necessary.
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Affiliation(s)
- Pinar Ural
- Department of Neurosurgery, Çaycuma Public Hospital, Zonguldak, Turkey
| | | | - Oktay Gürcan
- Department of Neurosurgery, Ankara City Hospital, Ankara, Turkey
| | - Atilla Kazanci
- Faculty of Medicine, Department of Neurosurgery, Yıldırım Beyazıt University Ankara, Turkey
| | - Ahmet G Gürçay
- Faculty of Medicine, Department of Neurosurgery, Yıldırım Beyazıt University Ankara, Turkey
| | - Mehmet Ö Özateş
- Department of Neurosurgery, Ankara City Hospital, Ankara, Turkey
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Gunewardene N, Ma Y, Lam P, Wagstaff S, Cortez-Jugo C, Hu Y, Caruso F, Richardson RT, Wise AK. Developing the supraparticle technology for round window-mediated drug administration into the cochlea. J Control Release 2023; 361:621-635. [PMID: 37572963 DOI: 10.1016/j.jconrel.2023.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023]
Abstract
The semi-permeable round window membrane (RWM) is the gateway to the cochlea. Although the RWM is considered a minimally invasive and clinically accepted route for localised drug delivery to the cochlea, overcoming this barrier is challenging, hindering development of effective therapies for hearing loss. Neurotrophin 3 (NT3) is an emerging treatment option for hearing loss, but its therapeutic effect relies on sustained delivery across the RWM into the cochlea. Silica supraparticles (SPs) are drug delivery carriers capable of providing long-term NT3 delivery, when injected directly into the guinea pig cochlea. However, for clinical translation, a RWM delivery approach is desirable. Here, we aimed to test approaches to improve the longevity and biodistribution of NT3 inside the cochlea after RWM implantation of SPs in guinea pigs and cats. Three approaches were tested (i) coating the SPs to slow drug release (ii) improving the retention of SPs on the RWM using a clinically approved gel formulation and (iii) permeabilising the RWM with hyaluronic acid. A radioactive tracer (iodine 125: 125I) tagged to NT3 (125I NT3) was loaded into the SPs to characterise drug pharmacokinetics in vitro and in vivo. The neurotrophin-loaded SPs were coated using a chitosan and alginate layer-by-layer coating strategy, named as '(Chi/Alg)SPs', to promote long term drug release. The guinea pigs were implanted with 5× 125I NT3 loaded (Chi/Alg) SPs on the RWM, while cats were implanted with 30× (Chi/Alg) SPs. A cohort of animals were also implanted with SPs (controls). We found that the NT3 loaded (Chi/Alg)SPs exhibited a more linear release profile compared to NT3 loaded SPs alone. The 125I NT3 loaded (Chi/Alg)SPs in fibrin sealant had efficient drug loading (~5 μg of NT3 loaded per SP that weights ~50 μg) and elution capacities (~49% over one month) in vitro. Compared to the SPs in fibrin sealant, the (Chi/Alg)SPs in fibrin sealant had a significantly slower 125I NT3 drug release profile over the first 7 days in vitro (~12% for (Chi/Alg) SPs in fibrin sealant vs ~43% for SPs in fibrin sealant). One-month post-implantation of (Chi/Alg) SPs, gamma count measurements revealed an average of 0.3 μg NT3 remained in the guinea pig cochlea, while for the cat, 1.3 μg remained. Histological analysis of cochlear tissue revealed presence of a 125I NT3 signal localised in the basilar membrane of the lower basal turn in some cochleae after 4 weeks in guinea pigs and 8 weeks in cats. Comparatively, and in contrast to the in vitro release data, implantation of the SPs presented better NT3 retention and distribution inside the cochlea in both the guinea pigs and cats. No significant difference in drug entry was observed upon acute treatment of the RWM with hyaluronic acid. Collectively, our findings indicate that SPs and (Chi/Alg)SPs can facilitate drug transfer across the RWM, with detectable levels inside the cat cochlea even after 8 weeks with the intracochlear approach. This is the first study to examine neurotrophin pharmacokinetics in the cochlea for such an extended period of times in these two animal species. Whilst promising, we note that outcomes between animals were variable, and opposing results were found between in vitro and in vivo release studies. These findings have important clinical ramifications, emphasising the need to understand the physical properties and mechanics of this complex barrier in parallel with the development of therapies for hearing loss.
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Affiliation(s)
- Niliksha Gunewardene
- Bionics Institute, East Melbourne, Victoria 3002, Australia; Department of Medical Bionics, The University of Melbourne, Fitzroy, Victoria 3065, Australia.
| | - Yutian Ma
- Bionics Institute, East Melbourne, Victoria 3002, Australia; Department of Chemical Engineering, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Patrick Lam
- Bionics Institute, East Melbourne, Victoria 3002, Australia
| | | | - Christina Cortez-Jugo
- Department of Chemical Engineering, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Yingjie Hu
- Bionics Institute, East Melbourne, Victoria 3002, Australia; Department of Medical Bionics, The University of Melbourne, Fitzroy, Victoria 3065, Australia; Department of Chemical Engineering, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Frank Caruso
- Department of Chemical Engineering, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Rachael T Richardson
- Bionics Institute, East Melbourne, Victoria 3002, Australia; Department of Medical Bionics, The University of Melbourne, Fitzroy, Victoria 3065, Australia; Department of Surgery (Otolaryngology), University of Melbourne, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria 3002, Australia
| | - Andrew K Wise
- Bionics Institute, East Melbourne, Victoria 3002, Australia; Department of Medical Bionics, The University of Melbourne, Fitzroy, Victoria 3065, Australia.
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Bao J, Fu X, Wu Y, Yang S, Ren X, Fang X, Yuan Q, Xie Z, Seriwatanachai D. The healing capacity and osteogenesis pattern of demineralized dentin matrix (DDM)-fibrin glue (FG) compound. Sci Rep 2023; 13:13140. [PMID: 37573402 PMCID: PMC10423223 DOI: 10.1038/s41598-023-40258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023] Open
Abstract
Demineralized dentin matrix (DDM) is an osteoconductive and osteoinductive material that has been successfully used in sinus floor augmentation and alveolar ridge augmentation in clinical applications. It releases bone morphogenetic proteins (BMPs) and other growth factors, making DDM a suitable grafting material. However, the granular particle of DDM makes it difficult to anchor into the bone defect area. The aim of this study was to investigate the biological effects and osteoinductivity of the combination of DDM and Fibrin Glue (FG) at an optimal ratio on bone healing from a critical bone defect in an animal model. The mouse osteoblastic cell line (MC3T3-E1) was co-cultured with various ratios of DDM and FG to examine their effects on osteoblast proliferation and differentiation, as indicated by alkaline phosphatase (ALP) activity, osteocalcin (OC) production and mineralized nodules formation. The optimal ratio was then chosen for further study with a rabbit calvarial defective model, in which they were implanted with DDM or DDM-FG1 (1 g: 0.1 ml) and DDM-FG2 (1 g: 0.5 ml) compounds, or left blank for 2, 4, 8 and 12 weeks to investigate soft tissue and new bone regeneration. Micro-CT and histology analysis were used to evaluate the total grafting properties according to the different healing periods. The result from in vitro studies demonstrated that the ratio of 1:0.1 induced more ALP activity and mineralized nodules, while the ratio of 1: 0.5 (DDM-FG combined) induced more osteocalcin (OC) at specific time points. In the animal model, the 3D new bone volume in all DDM-FG treatment groups was significantly greater than that in the blank group at 2, 4, 8 and 12 weeks. Furthermore, the new bone volume was greater in DDM-FG2 when compared to the other groups during the early weeks of the healing period. In histological analysis, clusters of osteoblasts were formed adjacent to the DDM particles, and newly formed bone was observed in all groups, suggesting an osteoinductive property of DDM. Moreover, the greater new collagen synthesis observed at 4 weeks suggested that early bone healing was induced in the DDM-FG2 group. This study demonstrated that at an optimal ratio, the DDM-FG compound enhances osteogenic activities and bone regeneration.
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Affiliation(s)
- Jibo Bao
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, Thailand
- Department of Implantology, School and Hospital of Stomatology, Kunming Medical University, Hecheng International Community, Building C, No.1088 the Middle of Hai Yuan Road, Wuhua District, Kunming, Yunnan, People's Republic of China
- Yunnan Key Laboratory of Stomatology, Kunming, Yunnan, People's Republic of China
| | - Xunan Fu
- Department of Chenggong Dental Clinic, School and Hospital of Stomatology, Chenggong New District, Kunming Medical University, University Town, Yuhua Street, Kunming, Yunnan, People's Republic of China
| | - Yirong Wu
- Department of The Second Dental Clinic, School and Hospital of Stomatology, Kunming Medical University, Yuantong Street, Wuhua District, Kunming, Yunnan, People's Republic of China
| | - Shengyin Yang
- Department of The First Dental Clinic, School and Hospital of Stomatology, Kunming Medical University, Hongyun Street, Wuhua District, Kunming, Yunnan, People's Republic of China
| | - Xiaobin Ren
- Department of Periodontics, School and Hospital of Stomatology, Kunming Medical University, Hecheng International Community, Building C, Wuhua District, Kunming, Yunnan, People's Republic of China
| | - Xingchen Fang
- School of Stomatology, Kunming Medical University, Chenggong District, Chunrong West Road, Kunming, Yunnan, People's Republic of China
| | - Quan Yuan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Zhigang Xie
- Department of Implantology, School and Hospital of Stomatology, Kunming Medical University, Hecheng International Community, Building C, No.1088 the Middle of Hai Yuan Road, Wuhua District, Kunming, Yunnan, People's Republic of China.
- Yunnan Key Laboratory of Stomatology, Kunming, Yunnan, People's Republic of China.
| | - Dutmanee Seriwatanachai
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, Thailand.
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Bojan AJ, Stadelmann VA, Wu D, Pujari-Palmer M, Insley G, Sundh D, Persson C, Engqvist H, Procter P. A new bone adhesive candidate- does it work in human bone? An ex-vivo preclinical evaluation in fresh human osteoporotic femoral head bone. Injury 2022; 53:1858-1866. [PMID: 35469636 DOI: 10.1016/j.injury.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The fixation of small intraarticular bone fragments is clinically challenging and an obvious first orthopaedic indication for an effective bone adhesive. In the present study the feasibility of bonding freshly harvested human trabecular bone with OsSticR, a novel phosphoserine modified cement, was evaluated using a bone cylinder model pull-out test and compared with a commercial fibrin tissue adhesive. METHODS Femoral heads (n=13) were collected from hip fracture patients undergoing arthroplasty and stored refrigerated overnight in saline medium prior to testing. Cylindrical bone cores with a pre-inserted bone screw, were prepared using a coring tool. Each core was removed and glued back in place with either the bone adhesive (α-tricalcium phosphate, phosphoserine and 20% trisodium citrate solution) or the fibrin glue. All glued bones were stored in bone medium at 37°C. Tensile loading, using a universal testing machine (5 kN load cell), was applied to each core/head. For the bone adhesive, bone cores were tested at 2 (n=13) and 24 (n=11) hours. For the fibrin tissue adhesive control group (n=9), bone cores were tested exclusively at 2 hours. The femoral bone quality was evaluated with micro-CT. RESULTS The ultimate pull-out load for the bone adhesive at 2 hours ranged from 36 to 171 N (mean 94 N, SD 42 N). At 24 hours the pull-out strength was similar, 47 to 198 N (mean 123 N, SD 43 N). The adhesive failure usually occurred through the adhesive layer, however in two samples, at 167 N and 198 N the screw pulled out of the bone core. The fibrin tissue adhesive group reached a peak force of 8 N maximally at 2 hours (range 2.8-8 N, mean 5.4 N, SD 1.6 N). The mean BV/TV for femoral heads was 0.15 and indicates poor bone quality. CONCLUSION The bone adhesive successfully glued wet and fatty tissue of osteoporotic human bone cores. The mean ultimate pull-out force of 123 N at 24 hours corresponds to ∼ 300 kPa shear stress acting on the bone core. These first ex-vivo results in human bone are a promising step toward potential clinical application in osteochondral fragment fixation.
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Affiliation(s)
- Alicja J Bojan
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Vincent A Stadelmann
- Department of Teaching, Research, and Development, Schulthess Klinik, Zürich, Switzerland
| | - Dan Wu
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | | | - Gerard Insley
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Daniel Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Cecilia Persson
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Håkan Engqvist
- Department of Materials Science and Engineering, Uppsala University, Sweden
| | - Philip Procter
- Department of Materials Science and Engineering, Uppsala University, Sweden
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Bozkurt E, Uslu MÖ. Evaluation of the effects of platelet-rich fibrin, concentrated growth factors, and autologous fibrin glue application on wound healing following gingivectomy and gingivoplasty operations: a randomized controlled clinical trial. Quintessence Int 2022; 53:328-341. [PMID: 34927405 DOI: 10.3290/j.qi.b2449819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF), concentrated growth factors (CGF), and autologous fibrin glue (AFG) application on early wound healing after gingivectomy and gingivoplasty operations. METHOD AND MATERIALS In this split-mouth study, gingivectomy and gingivoplasty surgery were performed on 19 patients. The postoperative PRF, CGF, and AFG applied areas were compared with the control regions. On days 0, 7, 14, and 28, the surgical area was stained with a plaque-disclosing agent and evaluated in the ImageJ program. Wound healing was evaluated with H2O2 test, visual analog scale for pain, and Landry, Turnbull, and Howley (LTH) wound healing index on days 7, 14, and 28. The patients were asked to evaluate their esthetic perceptions on a visual analog scale. RESULTS The amount of staining at days 7 and 14 was found to be significantly higher in the control group than in the test groups, but there was no difference between the test groups. LTH index values of the control group at days 7, 14, and 28 were found to be significantly lower than the test groups. There was no significant difference between the groups in the epithelialization assessment performed with the H2O2 test. It was observed that the use of platelet concentrate at day 7 reduced postoperative early pain. Patients were highly satisfied with postoperative esthetics. CONCLUSION After gingivectomy and gingivoplasty operations, PRF, CGF, and AFG application were found to have positive effects on wound healing. However, PRF, CGF, and AFG applications were not superior to each other in terms of secondary wound healing.
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Niu Q, He J, Wu M, Liu J, Lu X, Zhang L, Jin Z. Transplantation of bone marrow mesenchymal stem cells and fibrin glue into extraction socket in maxilla promoted bone regeneration in osteoporosis rat. Life Sci 2022; 290:119480. [PMID: 33862113 DOI: 10.1016/j.lfs.2021.119480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/03/2021] [Accepted: 03/31/2021] [Indexed: 11/20/2022]
Abstract
AIMS Bone defect repair in osteoporosis remains a tremendous challenge for clinicians due to increased bone metabolism resulted from estrogen deficiency. This study aims to investigate the effect of bone marrow mesenchymal stem cells (BMSCs) combined with fibrin glue (FG) in the extraction socket healing process of osteoporosis rats, as well as estimate the role of estrogen receptors (ERs) played in BMSCs differentiation in vitro and in the alveolar bone reconstruction process in vivo. MAIN METHODS Forty rats were randomly divided into four groups, under general anesthesia, three groups underwent bilateral ovariectomy(OVX) and one group with the sham operation. Three months later, the osteogenic ability of BMSCs, isolated from healthy and osteoporosis rats, respectively, was tested. The ERα and ERβ mRNA expression in BMSCs was also evaluated by RT-PCR analysis. In vivo experiment, Micro-CT detection, histological and immunofluorescent analysis, tissue PCR was conducted up to 2, 4 and 6 weeks after transplantation of BMSCs/FG to assess the newly formed bone in the extraction socket. KEY FINDINGS The BMSCs from osteoporosis rats displayed weaker osteogenic potential and lower ERs expression compared with the BMSCs from healthy rats. Newly formed bone tissue filled the socket defect in BMSCs/FG treated VOX rats after six weeks, which was comparable to the sham group, while reduced ERs expression was found in the regenerated bone of the OVX group. SIGNIFICANCE The BMSCs seeded within FG might provide an alternative therapeutic method for repairing the extraction socket defect in osteoporosis condition.
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Affiliation(s)
- Qiannan Niu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jiaojiao He
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Minke Wu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jia Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Xiaolin Lu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Liang Zhang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Stomatology, The Air Force 986 Hospital, Xi'an, People's Republic of China.
| | - Zuolin Jin
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, People's Republic of China; Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China.
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Marinaro F, Silva JM, Barros AA, Aroso IM, Gómez-Blanco JC, Jardin I, Lopez JJ, Pulido M, de Pedro MÁ, Reis RL, Sánchez-Margallo FM, Casado JG, López E. A Fibrin Coating Method of Polypropylene Meshes Enables the Adhesion of Menstrual Blood-Derived Mesenchymal Stromal Cells: A New Delivery Strategy for Stem Cell-Based Therapies. Int J Mol Sci 2021; 22:13385. [PMID: 34948187 PMCID: PMC8706515 DOI: 10.3390/ijms222413385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022] Open
Abstract
Polypropylene (PP) mesh is well-known as a gold standard of all prosthetic materials of choice for the reinforcement of soft tissues in case of hernia, organ prolapse, and urinary incontinence. The adverse effects that follow surgical mesh implantation remain an unmet medical challenge. Herein, it is outlined a new approach to allow viability and adhesion of human menstrual blood-derived mesenchymal stromal cells (MenSCs) on PP surgical meshes. A multilayered fibrin coating, based on fibrinogen and thrombin from a commercial fibrin sealant, was optimized to guarantee a homogeneous and stratified film on PP mesh. MenSCs were seeded on the optimized fibrin-coated meshes and their adhesion, viability, phenotype, gene expression, and immunomodulatory capacity were fully evaluated. This coating guaranteed MenSC viability, adhesion and did not trigger any change in their stemness and inflammatory profile. Additionally, MenSCs seeded on fibrin-coated meshes significantly decreased CD4+ and CD8+ T cell proliferation, compared to in vitro stimulated lymphocytes (p < 0.0001). Hence, the proposed fibrin coating for PP surgical meshes may allow the local administration of stromal cells and the reduction of the exacerbated inflammatory response following mesh implantation surgery. Reproducible and easy to adapt to other cell types, this method undoubtedly requires a multidisciplinary and translational approach to be improved for future clinical uses.
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Affiliation(s)
- Federica Marinaro
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
| | - Joana M. Silva
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal; (J.M.S.); (A.A.B.); (I.M.A.); (R.L.R.)
- ICVS/3B’s-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
| | - Alexandre A. Barros
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal; (J.M.S.); (A.A.B.); (I.M.A.); (R.L.R.)
- ICVS/3B’s-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
| | - Ivo M. Aroso
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal; (J.M.S.); (A.A.B.); (I.M.A.); (R.L.R.)
- ICVS/3B’s-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
| | - Juan C. Gómez-Blanco
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
| | - Isaac Jardin
- Cell Physiology Research Group, Department of Physiology, University of Extremadura, 10003 Cáceres, Spain; (I.J.); (J.J.L.)
- Institute of Molecular Pathology Biomarkers, University of Extremadura, 10003 Cáceres, Spain;
| | - Jose J. Lopez
- Cell Physiology Research Group, Department of Physiology, University of Extremadura, 10003 Cáceres, Spain; (I.J.); (J.J.L.)
- Institute of Molecular Pathology Biomarkers, University of Extremadura, 10003 Cáceres, Spain;
| | - María Pulido
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
| | - María Ángeles de Pedro
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
| | - Rui L. Reis
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal; (J.M.S.); (A.A.B.); (I.M.A.); (R.L.R.)
- ICVS/3B’s-PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
| | - Francisco Miguel Sánchez-Margallo
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Javier G. Casado
- Institute of Molecular Pathology Biomarkers, University of Extremadura, 10003 Cáceres, Spain;
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
- Immunology Unit, Department of Physiology, University of Extremadura, 10003 Cáceres, Spain
| | - Esther López
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain; (J.C.G.-B.); (M.P.); (M.Á.d.P.); (E.L.)
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Ivarsson M, Prenkert M, Cheema A, Wretenberg P, Andjelkov N. Mussel Adhesive Protein as a Promising Alternative to Fibrin for Scaffold Fixation during Cartilage Repair Surgery. Cartilage 2021; 13:663S-671S. [PMID: 31729255 PMCID: PMC8804795 DOI: 10.1177/1947603519887319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Fibrin has been used as a standard material for scaffold fixation during cartilage repair surgery. Most of the commercially available fibrin preparations need an additional method for scaffold fixation, most often with sutures, thus damaging the surrounding healthy cartilage. There is therefore a need to find alternatives to this method. In our study, we have investigated the potential possibility to use mussel adhesive protein as such an alternative. METHODS In this study, hydrophobic plastic was coated with the mussel adhesive protein Mefp-1 as well as with other cell adhesives (poly-lysine, fibronectin, and collagen). Human keratinocytes and chondrocytes were seeded on these substrates at 37°C in culture medium, followed by analysis of attachment and proliferation by crystal violet staining and metabolic labelling. Performance of Mefp-1 and fibrin as tissue glues were estimated by tensional force resistance measurement of moist porcine dermis (as a correlate to scaffold) glued to dermis, cartilage, or bone at 37°C. RESULTS Mefp-1 supported maximal cell attachment at a coating density of approximately 1 µg/cm2. This was at least as good as the other adhesives tested. In addition, it supported cell proliferation at least as good as regular tissue culture plastic over a 7-day period. Measurement of tensional force resistance showed that Mefp-1 performed equally well as fibrin when porcine dermis was glued to cartilage and bone at the same concentration. Separation of the moist tissues after 15-minute incubation required a force of approximately 1 N/cm2 for both compounds. CONCLUSIONS Mefp-1 show properties that qualify it as a compound that potentially could replace fibrin as a tissue glue for scaffold fixation. Given the possibilities to modify this protein by bioengineering, it is likely that the properties can be further improved.
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Affiliation(s)
- Mikael Ivarsson
- Department of Health Sciences,
University of Örebro, Örebro, Sweden
| | - Malin Prenkert
- Department of Health Sciences,
University of Örebro, Örebro, Sweden
| | - Annam Cheema
- Department of Health Sciences,
University of Örebro, Örebro, Sweden
| | - Per Wretenberg
- Department of Orthopaedics, School of
Medical Sciences, Örebro University, Örebro, Sweden
| | - Nenad Andjelkov
- Department of Orthopedics, Regional
Hospital Västmanland, Västerås, Sweden
- Nenad Andjelkov, Department of Orthopedics,
Västmanlands Regional Hospital, Västerås 248001, Sweden.
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Kabir MA, Hirakawa A, Zhu B, Yokozeki K, Shakya M, Huang B, Akazawa T, Todoh M, Murata M. Mechanical Properties of Human Concentrated Growth Factor (CGF) Membrane and the CGF Graft with Bone Morphogenetic Protein-2 (BMP-2) onto Periosteum of the Skull of Nude Mice. Int J Mol Sci 2021; 22:11331. [PMID: 34768759 PMCID: PMC8582862 DOI: 10.3390/ijms222111331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022] Open
Abstract
Concentrated growth factor (CGF) is 100% blood-derived, cross-linked fibrin glue with platelets and growth factors. Human CGF clot is transformed into membrane by a compression device, which has been widely used clinically. However, the mechanical properties of the CGF membranes have not been well characterized. The aims of this study were to measure the tensile strength of human CGF membrane and observe its behavior as a scaffold of BMP-2 in ectopic site over the skull. The tensile test of the full length was performed at the speed of 2mm/min. The CGF membrane (5 × 5 × 2 mm3) or the CGF/BMP-2 (1.0 μg) membrane was grafted onto the skull periosteum of nude mice (5-week-old, male), and harvested at 14 days after the graft. The appearance and size of the CGF membranes were almost same for 7 days by soaking at 4 °C in saline. The average values of the tensile strength at 0 day and 7 days were 0.24 MPa and 0.26 MPa, respectively. No significant differences of both the tensile strength and the elastic modulus were found among 0, 1, 3, and 7 days. Supra-periosteal bone induction was found at 14 days in the CGF/BMP-2, while the CGF alone did not induce bone. These results demonstrated that human CGF membrane could become a short-term, sticky fibrin scaffold for BMP-2, and might be preserved as auto-membranes for wound protection after the surgery.
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Affiliation(s)
- Md. Arafat Kabir
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Kanazawa 061-0293, Japan; (M.A.K.); (B.Z.); (K.Y.); (M.S.)
| | - Akihiro Hirakawa
- Biomechanical Design Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo 060-0819, Japan; (A.H.); (M.T.)
| | - Bowen Zhu
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Kanazawa 061-0293, Japan; (M.A.K.); (B.Z.); (K.Y.); (M.S.)
| | - Kenji Yokozeki
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Kanazawa 061-0293, Japan; (M.A.K.); (B.Z.); (K.Y.); (M.S.)
| | - Mamata Shakya
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Kanazawa 061-0293, Japan; (M.A.K.); (B.Z.); (K.Y.); (M.S.)
| | - Bingzhen Huang
- Corefront Corporation, 2-11 Ichitanihonmura-cho, Shinjuku-ku, Tokyo 162-0845, Japan;
| | - Toshiyuki Akazawa
- Industrial Technology and Environment Research Development, Hokkaido Research Organization, Kita 19-jo Nishi 11-chome, Kita-ku, Sapporo 060-0819, Japan;
| | - Masahiro Todoh
- Biomechanical Design Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo 060-0819, Japan; (A.H.); (M.T.)
| | - Masaru Murata
- Division of Oral Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Kanazawa 061-0293, Japan; (M.A.K.); (B.Z.); (K.Y.); (M.S.)
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Stefaniuk D, Misztal T, Pięt M, Zając A, Kopycińska M, Matuszewska A, Ruminowicz-Stefaniuk M, Matuszewski Ł, Marcińczyk N, Belcarz A, Żuchowski J, Skrabalak I, Grąz M, Ciołek B, Paduch R, Jaszek M. Thromboelastometric Analysis of Anticancer Cerrena unicolor Subfractions Reveal Their Potential as Fibrin Glue Drug Carrier Enhancers. Biomolecules 2021; 11:biom11091263. [PMID: 34572476 PMCID: PMC8470457 DOI: 10.3390/biom11091263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022] Open
Abstract
In this study, the influence of two subfractions (with previously proven anti-cancer properties) isolated from wood rot fungus Cerrena unicolor on the formation of a fibrin clot was investigated in the context of potential use as fibrin glue and sealant enhancers and potential wound healing agents. With the use of ROTEM thromboelastometry, we demonstrated that, in the presence of fibrinogen and thrombin, the S6 fraction accelerated the formation of a fibrin clot, had a positive effect on its elasticity modulus, and enhanced the degree of fibrin cross-linking. The S5 fraction alone showed no influence on the fibrin coagulation process; however, in the presence of fibrin, it exhibited a decrease in anti-proliferative properties against the HT-29 line, while it increased the proliferation of cells in general at a concentration of 100 µg/mL. Both fractions retained their proapoptotic properties to a lesser degree. In combination with the S6 fraction in the ratio of 1:1 and 1:3, the fractions contributed to increased inhibition of the activity of matrix metalloproteinases (MMPs). This may suggest anti-metastatic activity of the combined fractions. In conclusion, the potential of the fractions isolated from the C. unicolor secretome to be used as a means of improving the wound healing process was presented. The potential for delivering agents with cytostatic properties introduced far from the site of action or exerting a pro-proliferative effect at the wound site with the aid of a fibrin sealant was demonstrated.
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Affiliation(s)
- Dawid Stefaniuk
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
- Correspondence: (D.S.); (T.M.)
| | - Tomasz Misztal
- Department of Physical Chemistry, Faculty of Pharmacy, Medical University of Bialystok, 15-089 Białystok, Poland
- Correspondence: (D.S.); (T.M.)
| | - Mateusz Pięt
- Department of Virology and Immunology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (M.P.); (M.K.); (R.P.)
| | - Adrian Zając
- Department of Functional Anatomy and Cytobiology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland;
| | - Magdalena Kopycińska
- Department of Virology and Immunology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (M.P.); (M.K.); (R.P.)
| | - Anna Matuszewska
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
| | - Marta Ruminowicz-Stefaniuk
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
| | - Łukasz Matuszewski
- Department of Paediatric Orthopaedics and Rehabilitation, Faculty of Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Natalia Marcińczyk
- Department of Biopharmacy, Faculty of Pharmacy, Medical University of Bialystok, 15-089 Białystok, Poland;
| | - Anna Belcarz
- Chair and Department of Biochemistry and Biotechnology, Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Jerzy Żuchowski
- Department of Biochemistry, Institute of Soil Science and Plant Cultivation—State Research Institute, 24-100 Puławy, Poland;
| | - Ilona Skrabalak
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
| | - Marcin Grąz
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
| | - Beata Ciołek
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
| | - Roman Paduch
- Department of Virology and Immunology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (M.P.); (M.K.); (R.P.)
| | - Magdalena Jaszek
- Department of Biochemistry and Biotechnology, Institute of Biological Sciences, Maria Curie-Skłodowska University, 20-033 Lublin, Poland; (A.M.); (M.R.-S.); (I.S.); (M.G.); (B.C.); (M.J.)
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Takizawa K, Okazaki D, Takegawa Y, Koga Y, Sagata M, Michishita K, Shinya N. Evaluation of the hemostatic effect of a combination of hemostatic agents and fibrin glue in a rabbit venous hemorrhage model. BMC Neurol 2021; 21:270. [PMID: 34233632 PMCID: PMC8262001 DOI: 10.1186/s12883-021-02272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In neurosurgery, it is important to use local hemostatic agents. We have explored a more powerful method of hemostasis by the combination of commercially available hemostatic agents with fibrin glue in the hopes of synergistic effects. METHOD A bleeding model was constructed by puncturing the rabbit posterior vena cava with a needle. After applying the sample to the bleeding point, compression was performed for 10 s. If temporary hemostasis was achieved after pressure release, a 30 s wash was performed to confirm that ultimate hemostasis was achieved. Up to three hemostasis attempts were performed on the same bleeding point until hemostasis was achieved, and the number of attempts required for hemostasis was counted. If hemostasis was not achieved after three attempts, it was counted as four times. Four groups were evaluated: (1) gelatin sponge alone, (2) gelatin sponge + fibrin glue, (3) oxidized cellulose alone, and (4) oxidized cellulose + fibrin glue; each group was tested 16 times. RESULTS The median value (range minimum value-maximum value) of the number of hemostatic attempts in Group 1 to Group 4 was 3 (1-4), 1 (1-1), 4 (4-4), and 4 (2-4). In Group 2, there were two test exclusions owing to deviations of the test procedure. CONCLUSIONS The compatibility of gelatin sponge and fibrin glue was very good, with a very strong and rapid hemostatic effect compared to other methods, showed its usefulness. This combination method may be effective for a variety of venous hemorrhages in neurosurgery.
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Affiliation(s)
- Katsumi Takizawa
- Department of neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa-shi, Hokkaido, Japan
| | - Daiki Okazaki
- Non-Clinical Study Department, Non-Clinical Development Section, KM Biologics Co., Ltd, Kumamoto-shi, Kumamoto, Japan
| | - Yoshitaka Takegawa
- Medical Affairs Section, Research & Development Division, KM Biologics Co., Ltd, 1-6-1 Okubo, Kita-ku, Kumamoto-shi, , Kumamoto, Japan.
| | - Yuki Koga
- Non-Clinical Study Department, Non-Clinical Development Section, KM Biologics Co., Ltd, Kumamoto-shi, Kumamoto, Japan
| | - Masataka Sagata
- Non-Clinical Study Department, Non-Clinical Development Section, KM Biologics Co., Ltd, Kumamoto-shi, Kumamoto, Japan
| | - Kenichi Michishita
- Development Planning & Coordination Section, R&D Coordination & Administration Department, KM Biologics Co., Ltd, Kumamoto-shi, Kumamoto, Japan
| | - Noriko Shinya
- Non-Clinical Study Department, Non-Clinical Development Section, KM Biologics Co., Ltd, Kumamoto-shi, Kumamoto, Japan
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Richter M, Milstrey A, Zech S, Evers J, Grueter A, Raschke MJ, Ochman S. Comparison of clinically used bilayer collagen membrane and trilayer collagen prototype fixation stability in chondral defects at the talus - An experimental human specimen study. Foot Ankle Surg 2021; 27:35-39. [PMID: 32044174 DOI: 10.1016/j.fas.2020.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/02/2020] [Accepted: 01/27/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this human specimen experimental study was to compare the fixation stability of clinically used bilayer collagen membrane with fibrin glue with trilayer collagen prototype without fibrin glue in chondral defects at the medial or lateral talar shoulder (both matrices from Geistlich Pharma AG, Wollhusen, Switzerland). METHODS Eleven human specimens were used. The membranes were implanted in standardized chondral defects at the medial and lateral talar shoulder randomized. All tests were performed in load-control 15 kg. Range of motion ROM of each ankle was examined individually before testing. The average ROM was 10° dorsiflexion range 0°-20° and 30° plantarflexion range 20°-45°. 1,000 testing cycles with the defined ROM were performed. Two independent investigators, blinded to membrane and fixation type, visually assessed the membrane fixation integrity for peripheral detachment, area of defect uncovered, membrane constitution and delamination. RESULTS The clinically used bilayer collagen membrane plus fibrin glue showed higher fixation stability than the trilayer prototype (all p < 0.05). No significant differences occurred between medial and lateral talar shoulder location (all p > 0.05). CONCLUSIONS The fixation stability of the trilayer collagen prototype without fibrin glue is lower than of the clinically used bilayer membrane with fibrin glue in chondral defects at the medial and lateral talar shoulder in an experimental human specimen test. Clinical use of trilayer collagen prototype without fibrin glue has to be validated by clinical testing to evaluate if the lower stability of fixation is still sufficient.
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Affiliation(s)
- Martinus Richter
- Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany(2).
| | - Alexander Milstrey
- Department of Trauma-, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany
| | - Stefan Zech
- Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany(2)
| | - Julia Evers
- Department of Trauma-, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany
| | - Angelika Grueter
- Department of Trauma-, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany
| | - Michael J Raschke
- Department of Trauma-, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany
| | - Sabine Ochman
- Department of Trauma-, Hand and Reconstructive Surgery, University of Muenster, Muenster, Germany
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20
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Abstract
BACKGROUND This is an update of a Cochrane Review first published in the Cochrane Library (2010, Issue 7). To increase the success rate of assisted reproductive technologies (ARTs), adherence compounds such as hyaluronic acid (HA) have been introduced into subfertility management. Adherence compounds are added to the embryo transfer medium to increase the likelihood of embryo implantation, with the potential for higher clinical pregnancy and live birth rates. OBJECTIVES To determine whether adding adherence compounds to embryo transfer media could improve pregnancy outcomes, including improving live birth and decreasing miscarriage, in women undergoing assisted reproduction. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group Trials Register, CENTRAL, MEDLINE, Embase, and PsycINFO electronic databases on 7 January 2020 for randomised controlled trials that examined the effects of adherence compounds in embryo transfer media on pregnancy outcomes. Furthermore, we communicated with experts in the field, searched trials registries, checked reference lists of relevant studies, and conference abstracts were handsearched. SELECTION CRITERIA Only truly randomised controlled trials comparing embryo transfer media containing functional concentrations of adherence compounds to media with no or low adherence compound concentrations were included. DATA COLLECTION AND ANALYSIS Two review authors selected trials for inclusion according to the above criteria, after which the same two review authors independently extracted data for subsequent analysis. Statistical analysis was performed according to the guidelines developed by Cochrane. We combined data to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). We assessed statistical heterogeneity using the I² statistic. We used GRADE methods to assess the overall quality of evidence for the main comparisons. MAIN RESULTS We analysed 26 studies with a total of 6704 participants. Overall, the certainty of evidence was low to moderate: the main limitations were imprecision and/or heterogeneity. Compared to embryos transferred in media containing no or low (0.125 mg/mL) HA, the addition of functional (0.5 mg/mL) HA concentrations to the transfer media probably increases the live birth rate (RR 1.21, 95% CI 1.1 to 1.31; 10 RCTs, N = 4066; I² = 33%; moderate-quality evidence). This suggests that if the chance of live birth following no HA addition in media is assumed to be 33%, the chance following HA addition would be between 37% and 44%. The addition of HA may slightly decrease miscarriage rates (RR 0.82, 95% CI 0.67 to 1.00; 7 RCTs, N = 3091; I² = 66%; low-quality evidence). Nevertheless, when only studies with low risk of bias were included in the analysis, there was no conclusive evidence of a difference in miscarriage rates (RR 0.96, 95% CI 0.75 to 1.23; N = 2219; I² = 36%). Adding HA to transfer media probably results in an increase in both clinical pregnancy (RR 1.16, 95% CI 1.09 to 1.23; 17 studies, N = 5247; I² = 40%; moderate-quality evidence) and multiple pregnancy rates (RR 1.45, 95% CI 1.24 to 1.70; 7 studies, N = 3337; I² = 36%; moderate-quality evidence). We are uncertain of the effect of HA added to transfer media on the rate of total adverse events (RR 0.86, 95% CI 0.40 to 1.84; 3 studies, N = 1487; I² = 0%; low-quality evidence). AUTHORS' CONCLUSIONS Moderate-quality evidence shows improved clinical pregnancy and live birth rates with the addition of HA as an adherence compound in embryo transfer media in ART. Low-quality evidence suggests that adding HA may slightly decrease miscarriage rates, but when only studies at low risk of bias were included in the analysis, the results were inconclusive. HA had no clear effect on the rate of total adverse events. The increase in multiple pregnancy rates may be due to combining an adherence compound and transferring more than one embryo. Further studies of adherence compounds with single embryo transfer need to be undertaken.
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Affiliation(s)
- Devorah Heymann
- Department of Obstetrics and Gynaecology, Kaplan Medical Center, Rehovot, Israel
| | | | - Yuval Or
- Department of Obstetrics and Gynaecology, Kaplan Medical Center, Rehovot, Israel
- IVF Unit, Kaplan Medical Center, Rehovot, Israel
| | - Zeev Shoham
- Department of Obstetrics and Gynaecology, Kaplan Medical Center, Rehovot, Israel
- IVF Unit, Kaplan Medical Center, Rehovot, Israel
- Hadassah Medical School, Affiliated to the Hebrew University, Jerusalem, Israel
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21
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Ao Q, Wang S, He Q, Ten H, Oyama K, Ito A, He J, Javed R, Wang A, Matsuno A. Fibrin Glue/Fibronectin/Heparin-Based Delivery System of BMP2 Induces Osteogenesis in MC3T3-E1 Cells and Bone Formation in Rat Calvarial Critical-Sized Defects. ACS Appl Mater Interfaces 2020; 12:13400-13410. [PMID: 32091872 DOI: 10.1021/acsami.0c01371] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Bone morphogenetic proteins (BMPs) have been used to promote bone formation in many clinical scenarios. However, the BMPs are inherently unstable in vivo and therefore need to be combined with carriers for controlled delivery. In this study, an innovative and efficient fibrin glue/fibronectin/heparin (FG/Fn/Hep)-based delivery system was developed for controlled release of BMP2. The incorporation of heparin can significantly slow the release of BMP2 without substantially affecting the structure and stiffness of the FG/Fn. The BMP2 release from the FG/Fn/Hep-BMP2 hydrogel is largely dominated by hydrogel degradation rather than simple diffusion. In vitro release experiments and MC3T3-E1 cell induction experiments showed that BMP2 can be released steadily and can induce MC3T3-E1 cells to differentiate into osteoblasts efficiently. This process is characterized by the significantly increased expression of calcium deposits, alkaline phosphatase, runt-related transcription factor-2, osteopontin, osteocalcin, and collagen I in comparison with the negative control. In vivo assessments revealed that the FG/Fn/Hep-BMP2 hydrogel significantly promotes bone regeneration in a rat calvarial critical-sized defect model. Our investigation indicates that FG/Fn/Hep-BMP2 hydrogel holds promise to be used as an alternative biomaterial for the repair of bone defects.
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Affiliation(s)
- Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang 110122, China
- Institute of Regulatory Science for Medical Device, National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Shilin Wang
- Department of Tissue Engineering, China Medical University, Shenyang 110122, China
| | - Qing He
- State Key Laboratory of Biomembrane and Membrane Biotechnology, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Hirotomo Ten
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo 163-8001, Japan
| | - Kenichi Oyama
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo 163-8001, Japan
| | - Akihiro Ito
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo 163-8001, Japan
| | - Jing He
- Department of Tissue Engineering, China Medical University, Shenyang 110122, China
| | - Rabia Javed
- Department of Tissue Engineering, China Medical University, Shenyang 110122, China
| | - Aijun Wang
- Surgical Bioengineering Laboratory, Department of Surgery, School of Medicine, University of California, Davis, Sacramento, California 95817, United States
| | - Akira Matsuno
- Department of Neurosurgery, Teikyo University School of Medicine, Tokyo 163-8001, Japan
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22
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Earnshaw CH, Kinshuck AJ, Loh C, Tandon S, Jackson SR, Jones TM, Lancaster J. An audit of fifty patients receiving Artiss™ fibrin sealant in lateral selective neck dissections. Clin Otolaryngol 2020; 45:264-267. [PMID: 31782892 DOI: 10.1111/coa.13485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 04/08/2019] [Accepted: 11/21/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Charles H Earnshaw
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
| | - Andrew J Kinshuck
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
| | - Christopher Loh
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
| | - Sankalap Tandon
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
| | - Shaun R Jackson
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
| | - Terry M Jones
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Jeffrey Lancaster
- Otolaryngology/Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
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23
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Irwin RM, Bonassar LJ, Cohen I, Matuska AM, Commins J, Cole B, Fortier LA. The clot thickens: Autologous and allogeneic fibrin sealants are mechanically equivalent in an ex vivo model of cartilage repair. PLoS One 2019; 14:e0224756. [PMID: 31703078 PMCID: PMC6839864 DOI: 10.1371/journal.pone.0224756] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 10/21/2019] [Indexed: 02/07/2023] Open
Abstract
Fibrin sealants are commonly used in cartilage repair surgeries to adhere cells or grafts into a cartilage defect. Both autologous and commercial allogeneic fibrin sealants are used in cartilage repair surgeries, yet there are no studies characterizing and comparing the mechanical properties of fibrin sealants from all-autologous sources. The objectives of this study were to investigate (i) the effect of fibrinogen and thrombin sources on failure mechanics of sealants, and (ii) how sealants affect the adhesion of particulated cartilage graft material (BioCartilage) to surrounding cartilage under physiological loading. Allogeneic thrombin and fibrinogen were purchased (Tisseel), and autologous sources were prepared from platelet-rich plasma (PRP) and platelet-poor plasma (PPP) generated from human blood. To compare failure characteristics, sealants were sandwiched between cartilage explants and pulled to failure. The effect of sealant on the adhesion of BioCartilage graft to cartilage was determined by quantifying microscale strains at the graft-cartilage interface using an in vitro cartilage defect model subjected to shear loading at physiological strains well below failure thresholds. Fibrinogen sources were not equivalent; PRP fibrinogen created sealants that were more brittle, failed at lower strains, and resulted in sustained higher strains through the graft-cartilage interface depth compared to PPP and allogeneic sources. PPP clotted slower compared to PRP, suggesting PPP may percolate deeper into the repair to provide more stability through the tissue depth. There was no difference in bulk failure properties or microscale strains at the graft-cartilage interface between the purely autologous sealant (autologous thrombin + PPP fibrinogen) and the commercial allogeneic sealant. Clinical Significance: All-autologous fibrin sealants fabricated with PPP have comparable adhesion strength as commercial allogeneic sealants in vitro, whereas PRP creates an inferior all-autologous sealant that sustains higher strains through the graft-cartilage interface depth.
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Affiliation(s)
- Rebecca M. Irwin
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, United States of America
| | - Lawrence J. Bonassar
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, United States of America
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, United States of America
| | - Itai Cohen
- Department of Physics, Cornell University, Ithaca, New York, United States of America
| | - Andrea M. Matuska
- Research and Development, Arthrex Inc., Naples, Florida, United States of America
| | - Jacqueline Commins
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, United States of America
| | - Brian Cole
- Midwest Orthopedics at Rush, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Lisa A. Fortier
- College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- * E-mail:
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24
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Naganuma M, Akiyama M, Takaya H, Sakuma K, Kumagai K, Kawamoto S, Adachi O, Saiki Y. Maximization of the sealing effect of fibrin glue in aortic surgery. Gen Thorac Cardiovasc Surg 2019; 68:18-23. [PMID: 31177484 DOI: 10.1007/s11748-019-01155-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/02/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Fibrin glue is used to reinforce anastomosis in aortic surgery. There has not yet been a consensus on how it should be applied optimally. This study aimed to define the optimal condition of applying fibrin glue. METHODS In experiment 1, we determined the optimal condition for spraying fibrin glue using an expanded polytetrafluoroethylene graft within a needle hole. The length and area of the fibrin cap within the hole were measured. In experiment 2, methods for applying fibrinogen were assessed by comparing brushing and spraying. In experiment 3, swine aorta segments sutured with a Dacron graft were divided into the following three groups: nothing was applied; fibrinogen was sprayed and rubbed using brush. The aorta was clamped and blood was infused from an occlusion catheter inserted into the graft. The pressure at the first appearance of blood leak was recorded. RESULTS In experiment 1, among the four groups divided by the pressure and distance of spraying, the fibrin cap area in the group with 0.075 MPa and 2-cm spray distance was significantly larger than that in the group with 0.15 MPa and 2 cm (P < 0.01). In experiment 2, the fibrin cap area in the brushing group was significantly larger than that in the spraying group (P < 0.05). In experiment 3, the capacity to resist endoluminal pressure was higher in the brushing and combined spraying group compared with that in the sequential combined spraying group (P < 0.01). CONCLUSIONS The brush and spray methods showed excellent hemostatic outcomes.
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Affiliation(s)
- Masaaki Naganuma
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masatoshi Akiyama
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hiroki Takaya
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Kei Sakuma
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Kiichiro Kumagai
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Osamu Adachi
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan.
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Leite APS, Pinto CG, Tibúrcio FC, Sartori AA, de Castro Rodrigues A, Barraviera B, Ferreira RS, Filadelpho AL, Matheus SMM. Heterologous fibrin sealant potentiates axonal regeneration after peripheral nerve injury with reduction in the number of suture points. Injury 2019; 50:834-847. [PMID: 30922661 DOI: 10.1016/j.injury.2019.03.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/10/2019] [Accepted: 03/16/2019] [Indexed: 02/02/2023]
Abstract
The use of suture associated with heterologous fibrin sealant has been highlighted for reconstruction after peripheral nerve injury, having the advantage of being safe for clinical use. In this study we compared the use of this sealant associated with reduced number of stitches with conventional suture after ischiatic nerve injury. 36 Wistar rats were divided into 4 groups: Control (C), Denervated (D), ischiatic nerve neurotmesis (6 mm gap); Suture (S), epineural anastomosis after 7 days from neurotmesis, Suture + Fibrin Sealant (SFS), anastomosis with only one suture point associated with Fibrin Sealant. Catwalk, electromyography, ischiatic and tibial nerve, soleus muscle morphological and morphometric analyses were performed. The amplitude and latency values of the Suture and Suture + Fibrin Sealant groups were similar and indicative of nerve regeneration.The ischiatic nerve morphometric analysis in the Suture + Fibrin Sealant showed superior values related to axons and nerve fibers area and diameter when compared to Suture group. In the Suture and Suture + Fibrin Sealant groups, there was an increase in muscle weight and in fast fibers frequency, it was a decrease in the percentage of collagen compared to group Denervated and in the neuromuscular junctions, the synaptic boutons were reestablished.The results suggest a protective effect at the lesion site caused by the fibrin sealant use. The stitches reduction minimizes the trauma caused by the needle and it accelerates the surgical practice. So the heterologous fibrin sealant use in nerve reconstruction should be considered.
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Affiliation(s)
- Ana Paula Silveira Leite
- Graduate Program on the General Bases of Surgery, Botucatu Medical School, Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil; Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil.
| | - Carina Guidi Pinto
- Graduate Program on the General Bases of Surgery, Botucatu Medical School, Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil; Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil
| | - Felipe Cantore Tibúrcio
- Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil
| | - Arthur Alves Sartori
- Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil
| | | | - Benedito Barraviera
- The Center for the Study of Venoms and Venomous Animals, UNESP, Botucatu, SP, Brazil
| | - Rui Seabra Ferreira
- The Center for the Study of Venoms and Venomous Animals, UNESP, Botucatu, SP, Brazil
| | - André Luis Filadelpho
- Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil
| | - Selma Maria Michelin Matheus
- Department of Anatomy, Universidade Estadual Paulista "Júlio de Mesquita Filho", São Paulo State University (Unesp), Institute of Biosciences, Travessa da Rua Prof. Dr. Gilberti Moreno São Paulo, 18618-689, Botucatu, Brazil
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Frauz K, Teodoro LFR, Carneiro GD, Cristina da Veiga F, Lopes Ferrucci D, Luis Bombeiro A, Waleska Simões P, Elvira Álvares L, Leite R de Oliveira A, Pontes Vicente C, Seabra Ferreira R, Barraviera B, do Amaral MEC, Augusto M Esquisatto M, de Campos Vidal B, Rosa Pimentel E, Aparecida de Aro A. Transected Tendon Treated with a New Fibrin Sealant Alone or Associated with Adipose-Derived Stem Cells. Cells 2019; 8:cells8010056. [PMID: 30654437 PMCID: PMC6357188 DOI: 10.3390/cells8010056] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/07/2019] [Accepted: 01/07/2019] [Indexed: 01/01/2023] Open
Abstract
Tissue engineering and cell-based therapy combine techniques that create biocompatible materials for cell survival, which can improve tendon repair. This study seeks to use a new fibrin sealant (FS) derived from the venom of Crotalus durissus terrificus, a biodegradable three-dimensional scaffolding produced from animal components only, associated with adipose-derived stem cells (ASC) for application in tendons injuries, considered a common and serious orthopedic problem. Lewis rats had tendons distributed in five groups: normal (N), transected (T), transected and FS (FS) or ASC (ASC) or with FS and ASC (FS + ASC). The in vivo imaging showed higher quantification of transplanted PKH26-labeled ASC in tendons of FS + ASC compared to ASC on the 14th day after transection. A small number of Iba1 labeled macrophages carrying PKH26 signal, probably due to phagocytosis of dead ASC, were observed in tendons of transected groups. ASC up-regulated the Tenomodulin gene expression in the transection region when compared to N, T and FS groups and the expression of TIMP-2 and Scleraxis genes in relation to the N group. FS group presented a greater organization of collagen fibers, followed by FS + ASC and ASC in comparison to N. Tendons from ASC group presented higher hydroxyproline concentration in relation to N and the transected tendons of T, FS and FS + ASC had a higher amount of collagen I and tenomodulin in comparison to N group. Although no marked differences were observed in the other biomechanical parameters, T group had higher value of maximum load compared to the groups ASC and FS + ASC. In conclusion, the FS kept constant the number of transplanted ASC in the transected region until the 14th day after injury. Our data suggest this FS to be a good scaffold for treatment during tendon repair because it was the most effective one regarding tendon organization recovering, followed by the FS treatment associated with ASC and finally by the transplanted ASC on the 21st day. Further investigations in long-term time points of the tendon repair are needed to analyze if the higher tissue organization found with the FS scaffold will improve the biomechanics of the tendons.
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Affiliation(s)
- Katleen Frauz
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Luis Felipe R Teodoro
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Giane Daniela Carneiro
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Fernanda Cristina da Veiga
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Danilo Lopes Ferrucci
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - André Luis Bombeiro
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Priscyla Waleska Simões
- Engineering, Modeling and Applied Social Sciences Center (CECS), Biomedical Engineering Graduate Program (PPGEBM), Universidade Federal do ABC (UFABC), Alameda da Universidade s/n, 09606-045 São Bernardo do Campo, SP, Brazil.
| | - Lúcia Elvira Álvares
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Alexandre Leite R de Oliveira
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Cristina Pontes Vicente
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Rui Seabra Ferreira
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP ⁻ Universidade Estadual Paulista), Botucatu, SP, St. José Barbosa de Barros, 1780, Fazenda Experimental Lageado, 18610-307 Botucatu, SP, Brazil.
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP ⁻ Universidade Estadual Paulista), Botucatu, SP, St. José Barbosa de Barros, 1780, Fazenda Experimental Lageado, 18610-307 Botucatu, SP, Brazil.
| | - Maria Esméria C do Amaral
- Biomedical Sciences Graduate Program, Herminio Ometto University Center-UNIARARAS, Av. Dr. Maximiliano Baruto, 500, Jd. Universitário, 13607-339 Araras, SP, Brazil.
| | - Marcelo Augusto M Esquisatto
- Biomedical Sciences Graduate Program, Herminio Ometto University Center-UNIARARAS, Av. Dr. Maximiliano Baruto, 500, Jd. Universitário, 13607-339 Araras, SP, Brazil.
| | - Benedicto de Campos Vidal
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Edson Rosa Pimentel
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
| | - Andrea Aparecida de Aro
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas⁻UNICAMP, Charles Darwin, s/n, CP 6109, 13083-970 Campinas, SP, Brazil.
- Biomedical Sciences Graduate Program, Herminio Ometto University Center-UNIARARAS, Av. Dr. Maximiliano Baruto, 500, Jd. Universitário, 13607-339 Araras, SP, Brazil.
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Almeida DRP, Chin EK, Arjmand P, Velez G, Evans LP, Mahajan VB. Fibrin Glue and Internal Limiting Membrane Abrasion for Optic Disc Pit Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2018; 49:e271-e277. [PMID: 30566713 PMCID: PMC10887125 DOI: 10.3928/23258160-20181203-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/02/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe a novel surgical technique using pars plana vitrectomy (PPV), internal limiting membrane (ILM) abrasion, and intravitreal fibrin glue for the treatment of optic disc pit maculopathy. PATIENTS AND METHODS Surgical case series technique with scanning electron microscopy (SEM) of human post-mortem eyes. RESULTS Using SEM, the authors demonstrate the persistent adherence of vitreous fragments to the optic disc following induction of posterior vitreous detachment in human postmortem eyes. The authors describe a surgical technique using PPV, Tano Diamond Dusted Membrane Scraper for an ILM abrasion, intravitreal fibrin glue (Tisseel), and gas-air exchange to seal optic disc pits. The authors report successful long-term visual and anatomical outcomes in three patients. CONCLUSIONS Intravitreal fibrin glue, when combined with ILM abrasion, may be a viable treatment option for optic disc pit maculopathy with good short- and long-term visual acuity outcomes. SEM shows that ILM abrasion removes vitreous fragments, which are persistently adherent and may lead to failure with other interventional techniques. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e271-e277.].
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Mehrabani D, Khodakaram-Tafti A, Shaterzadeh-Yazdi H, Zamiri B, Omidi M. Comparison of the regenerative effect of adipose-derived stem cells, fibrin glue scaffold, and autologous bone graft in experimental mandibular defect in rabbit. Dent Traumatol 2018; 34:413-420. [PMID: 30187637 DOI: 10.1111/edt.12435] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIMS One of the main concerns for maxillofacial and orthopedic surgeons is finding a method to improve regeneration of large craniofacial bone defects. The aim of this study was to investigate the healing and regenerative effects of fibrin glue associated with adipose-derived stem cells (ADSCs) and fibrin glue scaffold alone with autologous bone grafts in experimental mandibular defects of the rabbit. METHODS Bilateral uni-cortical osteotomies were performed in the mandible of 20 male Dutch rabbits. The animals were randomly divided into 2 equal groups. In one group, the defect on the right side was treated by fibrin glue associated with ADSCs and the defect on the other side remained as the control. In another group, the defect on the right side was treated with fibrin glue and on the left side with autologous bone graft. After 28 and 56 days, five rabbits from each group were evaluated by computed tomography (CT) and histopathological examinations. RESULTS Coronal CT showed a remarkable reconstruction of cortical bone in the fibrin glue associated with ADSCs group at 28 and 56 days post-surgery. Histopathologically, new cortical bony bridge formation was seen increasingly in the fibrin glue, fibrin glue associated with ADSCs, and autologous bone graft groups after 28 days. Statistical analysis of the thickness of new cortical bone in the treatment versus control groups showed a significant difference between fibrin glue alone and fibrin glue associated with ADSCs groups (P = 0.02). No significant difference was found between the fibrin glue associated with ADSCs and the autologous bone graft groups (P > 0.05). CONCLUSIONS The healing process had a significant increase in the thickness of new cortical bone when fibrin glue scaffold associated with ADSCs was used.
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Affiliation(s)
- Davood Mehrabani
- Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Barbad Zamiri
- Department of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Omidi
- Department of Oral and Maxillofacial Radiology and Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Kobayashi K, Ichihara Y, Tano N, Fields L, Murugesu N, Ito T, Ikebe C, Lewis F, Yashiro K, Shintani Y, Uppal R, Suzuki K. Fibrin Glue-aided, Instant Epicardial Placement Enhances the Efficacy of Mesenchymal Stromal Cell-Based Therapy for Heart Failure. Sci Rep 2018; 8:9448. [PMID: 29930312 PMCID: PMC6013428 DOI: 10.1038/s41598-018-27881-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/11/2018] [Indexed: 02/07/2023] Open
Abstract
Transplantation of mesenchymal stromal cells (MSCs) is a promising new therapy for heart failure. However, the current cell delivery routes result in poor donor cell engraftment. We therefore explored the role of fibrin glue (FG)-aided, instant epicardial placement to enhance the efficacy of MSC-based therapy in a rat ischemic cardiomyopathy model. We identified a feasible and reproducible method to instantly produce a FG-MSC complex directly on the heart surface. This complex exhibited prompt, firm adhesion to the heart, markedly improving initial retention of donor MSCs compared to intramyocardial injection. In addition, maintenance of retained MSCs was enhanced using this method, together contributing the increased donor cell presence. Such increased donor cell quantity using the FG-aided technique led to further improved cardiac function in association with augmented histological myocardial repair, which correlated with upregulation of tissue repair-related genes. We identified that the epicardial layer was eliminated shortly after FG-aided epicardial placement of MSCs, facilitating permeation of the donor MSC's secretome into the myocardium enabling myocardial repair. These data indicate that FG-aided, on-site, instant epicardial placement enhances MSC engraftment, promoting the efficacy of MSC-based therapy for heart failure. Further development of this accessible, advanced MSC-therapy is justified.
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Affiliation(s)
- Kazuya Kobayashi
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yuki Ichihara
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Nobuko Tano
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Laura Fields
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Nilaani Murugesu
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Tomoya Ito
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Chiho Ikebe
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Fiona Lewis
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Kenta Yashiro
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yasunori Shintani
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Rakesh Uppal
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ken Suzuki
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
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Abstract
SummaryIn wound repair, fibrin has a multiplicity of activities, some of which are intrinsic to the protein itself and some attributable to other blood constituents associated with the fibrin clot. Fibrin sealants, which have been approved for hemostasis in the US and Europe, are occasionally used wounds to promote healing. However, inconsistency exists in the literature regarding the benefit of these preparations in the healing process. Morecrude fibrinogen preparations, such as cryoprecipitates made from the patient’s own blood on location, appear from the literature to have better utility in wounds than more purified fibrinogen preparations available through commercial sources. These divergent outcomes are likely attributable to additional blood-derived products being associated with cryo-precipitates compared to the relatively purified commercial fibrinogen preparations. Clearly standard preparations and methods of application of fibrin sealant need to be defined for each particular surgical setting to resolve the many ostensible discrepancies in the current literature. A corollary is that different fibrin sealant preparations are likely to be preferable for different clinical situations.
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Affiliation(s)
- Richard A F Clark
- Department of Biomedical Engineering, SUNY at Stony Brook, Stony Brook, New York 11795-8165, USA.
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31
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Mancini IA, Bolaños RAV, Brommer H, Castilho M, Ribeiro A, van Loon JP, Mensinga A, van Rijen MH, Malda J, van Weeren R. Fixation of Hydrogel Constructs for Cartilage Repair in the Equine Model: A Challenging Issue. Tissue Eng Part C Methods 2017; 23:804-814. [PMID: 28795641 PMCID: PMC7116030 DOI: 10.1089/ten.tec.2017.0200] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To report on the experiences with the use of commercial and autologous fibrin glue (AFG) and of an alternative method based on a 3D-printed polycaprolactone (PCL) anchor for the fixation of hydrogel-based scaffolds in an equine model for cartilage repair. METHODS In a first study, three different hydrogel-based materials were orthotopically implanted in nine horses for 1-4 weeks in 6 mm diameter full-thickness cartilage defects in the medial femoral trochlear ridge and fixated with commercially available fibrin glue (CFG). One defect was filled with CFG only as a control. In a second study, CFG and AFG were compared in an ectopic equine model. The third study compared the efficacy of AFG and a 3D-printed PCL-based osteal anchor for fixation of PCL-reinforced hydrogels in three horses for 2 weeks, with a 4-week follow-up to evaluate integration of bone with the PCL anchor. Short-term scaffold integration and cell infiltration were evaluated by microcomputed tomography and histology as outcome parameters. RESULTS The first study showed signs of subchondral bone resorption in all defects, including the controls filled with CFG only, with significant infiltration of neutrophils. Ectopically, CFG induced clear inflammation with strong neutrophil accumulation; AFG was less reactive, showing fibroblast infiltration only. In the third study the fixation potential for PCL-reinforced hydrogels of AFG was inferior to the PCL anchor. PCL reinforcement had disappeared from two defects and showed signs of dislodging in the remaining four. All six constructs fixated with the PCL anchor were still in place after 2 weeks. At 4 weeks, the PCL anchor showed good integration and signs of new bone formation. CONCLUSIONS The use of AFG should be preferred to xenogeneic products in the horse, but AFG is subject to individual variations and laborious to make. The PCL anchor provides the best fixation; however, this technique involves the whole osteochondral unit, which entails a different conceptual approach to cartilage repair.
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Affiliation(s)
- Irina A.D. Mancini
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Rafael A. Vindas Bolaños
- Cátedra de Cirugía de Especies Mayores, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Harold Brommer
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Miguel Castilho
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Alexandro Ribeiro
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes P.A.M. van Loon
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Anneloes Mensinga
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mattie H.P. van Rijen
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jos Malda
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Division of Surgery, Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René van Weeren
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Kasemkijwattana C, Rungsinaporn V, Siripisitsak T, Kongmalai P, Boonprasert R, Charoenthamruksa C, Hongeng S, Wongkajornsilp A, Muangsomboon S, Chaipinyo K, Chansiri K. Autologous Fibrin-Base Scaffold for Chondrocytes and Bone Marrow Mesenchymal Stem Cells Implantation: The Development and Comparison to Conventional Fibrin Glue. J Med Assoc Thai 2016; 99 Suppl 8:S99-S104. [PMID: 29901946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The authors developed the autologous fibrin-base scaffold for chondrocytes and bone marrow mesenchymal stem cells (BM-MSCs) implantation and evaluated cells viability in autologous fibrin-base scaffold comparing to commercial fibrin glue. MATERIAL AND METHOD The chondrocytes and BM-MSCs were seeded into autologous fibrin-base scaffold and commercial fibrin glue. The cell viability and proliferation were evaluated at 1 and 7 days. The histology were evaluated with hematoxylineosin (H&E) staining and cartilaginous matrices formation with Alcian blue, Saffanin-0, Toluidine blue, and Collagen type II staining at 6 weeks. The fixation of the scaffolds was observed. RESULTS The chondrocytes and BM-MSCs could not survive in commercial fibrin glue. The chondrocytes and BM-MSCs in autologous fibrin-base scaffold could proliferate and synthesize the cartilaginous matrices on Alcian blue, Saffanin-0, Toluidine blue, and Collagen type II staining at 6 weeks. The fixation strength is excellent. CONCLUSION The developed autologous fibrin-base scaffold can be used as the scaffold for chondrocytes and BM-MSCs implantation with potential to implant chondrocytes and BM-MSCs arthroscopically.
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Lassen MR, Solgaard S, Kjersgaard AG, Olsen C, Lind B, Mittet K, Ganes HC. A Pilot Study of the Effects of Vivostat Patient-derived Fibrin Sealant in Reducing Blood Loss in Primary Hip Arthroplasty. Clin Appl Thromb Hemost 2016; 12:352-7. [PMID: 16959690 DOI: 10.1177/1076029606291406] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A pilot study evaluated the effectiveness of Vivostat patient-derived fibrin sealant in reducing blood loss in patients who underwent primary hip arthroplasty. Eighty adult patients undergoing elective surgery were randomized to receive either Vivostat sealant or control (no additional hemostatic treatment). Patients allocated Vivostat sealant donated 120 mL of blood, which was then processed perioperatively to produce a fibrin sealant that was applied to the bleeding wound surfaces just before closure. Transfusion requirements, blood loss during surgery, drain volumes, and daily hematocrit and hemoglobin levels were measured. Hospitalization times, adverse events, and postoperative wound complications were also monitored. Blood loss during surgery and wound drainage volume was lower in the Vivostat group than in the control group, although the differences were not significantly different. Transfusion requirements (median, 270 mL of packed red blood cells) and hospitalization times (both median 7 days) were the same for both groups. No adverse events related to the use of Vivostat occurred. There were indications of a possible reduction in the incidence of postoperative wound oozing (15% vs 25%) and hematomas (6% vs 11%) with the use of Vivostat compared with the control group, although differences were not statistically significant. In conclusion, in this pilot study, use of Vivostat patient-derived fibrin in hip arthroplasty was not associated with a significant reduction in blood loss. Further studies, with larger numbers of patients, may be warranted to investigate a possible benefit of Vivostat in reducing postoperative wound complications.
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Zloto O, Vishnevskia-Dai V, Moisseiev J, Belkin M, Fabian ID. A Biological Tissue Adhesive and Dissolvent System for Intraocular Tumor Plaque Brachytherapy. Ophthalmic Surg Lasers Imaging Retina 2016; 47:163-70. [PMID: 26878450 DOI: 10.3928/23258160-20160126-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/10/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine a novel technique for simplified placement and removal of plaque brachytherapy by fibrin glue and urokinase (medac Gmbh, Hamburg, Germany). MATERIALS AND METHODS In six enucleated porcine eyes, plaques were placed on the episclera and fibrin glue was applied to cover it. Urokinase was used to dissolve the glue in three eyes and saline was used in three eyes. Adhesion strength was measured further on 15 plaques affixed to porcine eyes (glued in five with intact conjunctiva, glued in five with removed conjunctiva, and sutured in five). RESULTS Saline had no effect on the glue-plaque-eye complex, whereas the urokinase (0.38 mL ± 0.08 mL) easily dissolved the adhesion between the glue layer and surrounding tissues. The weight required to detach the plaques was 0.349 kg ± 0.173 kg for glued eyes with intact conjunctiva, 0.405 kg ± 0.083 kg for sutured eyes (P = .59), and 0.032 kg ± 0.004 kg for glued eyes without intact conjunctiva (P ≤ .015). CONCLUSIONS The usage of the biological adhesive and dissolvent system was applicable for plaque surgery in an ex vivo animal model.
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Eryılmaz A, Demirci B, Gunel C, Kacar Doger F, Yukselen O, Kurt Omurlu I, Basal Y, Agdas F, Basak S. Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation? Auris Nasus Larynx 2015; 43:62-7. [PMID: 26229017 DOI: 10.1016/j.anl.2015.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/05/2015] [Accepted: 06/22/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula. METHODS 40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale. RESULTS Inflammatory infiltration was found to be higher in "platelet-rich plasma" group than "fibrin tissue adhesive" and "synthetic tissue adhesive" groups. The fibroblastic activity of "platelet-rich plasma", "fibrin tissue adhesive" and "protein-based albumin glutaraldehyde" groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments. CONCLUSION These results shed light on the suggestion that platelet-rich plasma and fibrin tissue adhesive can be used in clinical studies to prevent pharyngocutaneous fistula.
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Affiliation(s)
- Aylin Eryılmaz
- Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey.
| | - Buket Demirci
- Department of Medical Pharmacology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ceren Gunel
- Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Firuzan Kacar Doger
- Department of Medical Pathology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ozden Yukselen
- Pathology Department, Aydin State Hospital, Aydın, Turkey
| | - Imran Kurt Omurlu
- Department of Biostatistics, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Yesim Basal
- Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Fatih Agdas
- Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Sema Basak
- Department of Otorhinolaryngology Head and Neck Surgery, Adnan Menderes University School of Medicine, Aydın, Turkey
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Mehanna RA, Nabil I, Attia N, Bary AA, Razek KA, Ahmed TAE, Elsayed F. The Effect of Bone Marrow-Derived Mesenchymal Stem Cells and Their Conditioned Media Topically Delivered in Fibrin Glue on Chronic Wound Healing in Rats. Biomed Res Int 2015; 2015:846062. [PMID: 26236740 PMCID: PMC4508387 DOI: 10.1155/2015/846062] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 02/05/2023]
Abstract
Bone marrow-derived mesenchymal stem cells (BM-MSCs) represent a modern approach for management of chronic skin injuries. In this work, we describe BM-MSCs application versus their conditioned media (CM) when delivered topically admixed with fibrin glue to enhance the healing of chronic excisional wounds in rats. Fifty-two adult male rats were classified into four groups after induction of large-sized full-thickness skin wound: control group (CG), fibrin only group (FG), fibrin + MSCs group (FG + SCs), and fibrin + CM group (FG + CM). Healing wounds were evaluated functionally and microscopically. Eight days after injury, number of CD68+ macrophages infiltrating granulation tissue was considerably higher in the latter two groups. Although--later--none of the groups depicted a substantially different healing rate, the quality of regenerated skin was significantly boosted by the application of either BM-MSCs or their CM both (1) structurally as demonstrated by the obviously increased mean area percent of collagen fibers in Masson's trichrome-stained skin biopsies and (2) functionally as supported by the interestingly improved epidermal barrier as well as dermal tensile strength. Thus, we conclude that topically applied BM-MSCs and their CM-via fibrin vehicle--could effectively improve the quality of healed skin in chronic excisional wounds in rats, albeit without true acceleration of wound closure.
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Affiliation(s)
- Radwa A. Mehanna
- Medical Physiology Department, Faculty of Medicine, Alexandria University, Dr Fahmi Abdel Meguid Street, Mowassat Building, El Shatby, Alexandria 21561, Egypt
- Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria 21514, Egypt
| | - Iman Nabil
- Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria 21514, Egypt
- Histology and Cell Biology Department, Faculty of Medicine, Alexandria University, Dr Fahmi Abdel Meguid Street, Mowassat Building, El Shatby, Alexandria 21561, Egypt
| | - Noha Attia
- Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria 21514, Egypt
- Histology and Cell Biology Department, Faculty of Medicine, Alexandria University, Dr Fahmi Abdel Meguid Street, Mowassat Building, El Shatby, Alexandria 21561, Egypt
| | - Amany A. Bary
- Pathology Department, Faculty of Medicine, Alexandria University, Dr Fahmi Abdel Meguid Street, Mowassat Building, El Shatby, Alexandria 21561, Egypt
| | - Khalid A. Razek
- Medical Research Institute, Alexandria University, 71 Victor Emanuel Street, Smouha, Alexandria 21615, Egypt
| | - Tamer A. E. Ahmed
- Medical Biotechnology Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications, New Borg El-Arab, P.O. Box 21934, Alexandria, Egypt
| | - Fatma Elsayed
- Cell Culture Department, Medical Research Institute, Alexandria University, 71 Victor Emanuel Street, Smouha, Alexandria 21615, Egypt
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Hong L, Chao Y, Guoqing C, Weidong T, Yu C. [Effects of different fibrin glue combination modes on the proliferation and viability of dental follicle cells]. Hua Xi Kou Qiang Yi Xue Za Zhi 2015; 33:135-140. [PMID: 26189228 PMCID: PMC7040993 DOI: 10.7518/hxkq.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 12/20/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study explores the effects of different fibrin glue combination modes on the survival, proliferation, and apoptosis of dental follicle cells (DFCs), as well as to evaluate the feasibility and effectiveness of fibrin glue as transplantation material. METHODS The membranes of surviving DFCs were marked using 3,3'-dioctadecyloxa carbocyanine perchlorate (DIO), and the cell number was counted by using ImageJ2x software. The apoptotic cells were marked with prodium iodide (PI). RESULTS Compared with that of the 3D-2 and 2D-1 groups, the degradation speed of the 3D-1 group was the slowest. DFCs could survive and grow well in fibrinogen with a concentration of 15 mg · mL⁻¹ supplemented with thrombin with a concentration of 2 U · mL⁻¹. In particular, the 3D-1 combination mode was significantly conducive to cell proliferation and stretching. CONCLUSION Fibrin glue can be used as an effective cell transplantation material. The different combination modes have certain effects on cell proliferation. The 3D-1 combination mode is more conducive to the survival and proliferation of DFCs than other modes.
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Zazgyva AM, Gurzu S, Jung I, Nagy Ö, Mühlfay G, Pop TS. S53P4 bioactive glass and fibrin glue for the treatment of osteochondral lesions of the knee - a preliminary in vivo study in rabbits. Rom J Morphol Embryol 2015; 56:1085-90. [PMID: 26662143 DOI: pmid/26662143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The role of the subchondral bone and the importance of treating both bone and cartilage in cases of chondral and osteochondral lesions of the knee have been highly emphasized. There are no current studies on the experimental use of bioactive glass S53P4 (BonAlive®) as granules in the treatment of osteochondral lesions of the knee. Our preliminary study was designed to establish an experimental model and assesses the effect of glass granules fixed with fibrin compared to fibrin alone as fillers of the osteochondral defects created in the weight-bearing and partial weight-bearing regions of the distal femur in six adult rabbits. We found that the size of the distal femur in adult domestic rabbits allows the creation of 4 mm diameter and 5 mm deep osteochondral defects on both the medial femoral condyle and the trochlea, bilaterally, without significantly affecting the activity level of the animals. Retention of the glass granules in the defects was achieved successfully using a commercially available fibrin sealant. At five weeks post-implantation, we found macroscopic and microscopic differences between the four types of defects. The use of bioactive glass S53P4 for filling condylar osteochondral defects in rabbit femora led to the initiation of an early bone repair process, observed at five weeks after implantation, while the filling of trochlear defects with fibrin glue resulted in the appearance of cartilaginous tissue characteristic of endochondral ossification.
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Kotsia AP, Brilakis ES, Karmpaliotis D. Thrombin injection for sealing epicardial collateral perforation during chronic total occlusion percutaneous coronary interventions. J Invasive Cardiol 2014; 26:E124-E126. [PMID: 25198496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Epicardial collateral perforation is a serious complication of retrograde chronic total occlusion percutaneous coronary intervention. We describe two cases of epicardial collateral perforation that were successfully sealed with local thrombin injection.
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Affiliation(s)
- Anna P Kotsia
- Dallas VA Medical Center (111A), 4500 South Lancaster Road, Dallas, TX 75216 USA.
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Pertici V, Laurin J, Marqueste T, Decherchi P. Comparison of a collagen membrane versus a fibrin sealant after a peroneal nerve section and repair: a functional and histological study. Acta Neurochir (Wien) 2014. [PMID: 24875612 DOI: 10.1016/s0140-6736(01)07978-8] [Citation(s) in RCA: 280] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND To date, fibrin sealant is considered to be one of the most effective substitutes to prevent post-operative fibrosis and to limit neuroma formation after nerve suture. Because fibrin sealant presents a number of drawbacks, more suitable techniques should be considered. The aim of this study was to functionally and histologically compare the efficiency of a fibrin sealant to a resorbable semi-permeable porcine type I collagen membrane after a peroneal nerve lesion and repair on rats. METHODS Rats were divided into four groups: (1) a SHAM group (n = 10) in which surgery was performed without damaging the nerve, (2) a LESION group (n = 15) in which the nerve was cut and immediately sutured without additional treatment, (3) a MEMBRANE group (n = 30) in which a collagen membrane was wrapped around the lesion site, and (4) a GLUE group (n = 30) in which the peroneal nerve was coated by fibrin sealant. Peroneal Functional Index (PFI), kinematic analysis of locomotion, muscular atrophy, axonal regrowth, and irritant ranking score (IRS) were performed during three months post-surgery. RESULTS Our results indicate that at the third month post-surgery, no difference in both the functional recovery and the histological measurement was observed between groups. However, no deleterious effect was observed following the use of the collagen membrane. Indeed, the porcine membrane was well-integrated into the host tissue, with no noticeable foreign body reaction at three months post-surgery. CONCLUSION Our preliminary results highlight the fact that the collagen membrane could be used as an alternative to fibrin sealant in peripheral nerve repair surgery. Indeed, animals in which the collagen membrane was used to wrap the lesion site exhibited similar functional and histological results as animals in which a fibrin sealant was used to coat the lesion. The greatest advantage of this membrane is that it could be used as a drug delivery device, regulated by its degradation rate.
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Affiliation(s)
- Vincent Pertici
- Aix-Marseille Université (AMU) and Centre National de la Recherche Scientifique (CNRS), UMR 7287 « Institut des Sciences du Mouvement (ISM) : Etienne-Jules MAREY », Equipe « Plasticité des Systèmes Nerveux et Musculaire », Parc Scientifique et Technologique de Luminy, Faculté des Sciences du Sport de Marseille, CC910 - 163 Avenue de Luminy, 13288, Marseille, Cedex 09, France
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Franco-Vidal V, Daculsi G, Bagot d'Arc M, Sterkers O, Smail M, Robier A, Bordure P, Claros P, Paiva A, Darrouzet V, Anthoine E, Bebear JP. Tolerance and osteointegration of TricOs(TM)/MBCP(®) in association with fibrin sealant in mastoid obliteration after canal wall-down technique for cholesteatoma. Acta Otolaryngol 2014; 134:358-65. [PMID: 24490704 DOI: 10.3109/00016489.2013.859394] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The TricOs™/MBCP(®) and fibrin sealant composite was a convenient, effective, and well-tolerated material for mastoid cavity filling and immediate reconstruction of the external auditory meatus after cholesteatoma surgery with canal wall down (CWD). OBJECTIVE To assess the tolerance and osteointegration of a bone graft substitute, TricOs™/MBCP(®), in association with fibrin sealant for filling the mastoid cavity after cholesteatoma surgery using the CWD technique. METHODS In this prospective observational study 57 patients with cholesteatoma suitable for CWD were recruited from April 2006 to April 2008 and followed up for 1 year. The mastoid cavity was filled with TricOs™/MBCP(®) followed by immediate reconstruction of the external auditory meatus covered with fascia temporalis and/or cartilage. The main outcome was skin tolerance assessed by a novel weighted score emphasizing long-term results. The typical weighted reference score was 1.67; skin tolerance was considered acceptable if 75% of patients had a score ≤ 1.67. Secondary outcomes were otorrhea and/or otalgia, hearing, and osteointegration assessed through computed tomography scanning at 12 months. RESULTS Forty-one patients had a complete follow-up; 34 (82.3%) patients achieved the main end point with scores ≤ 1.67. Otorrhea decreased postoperatively. No otalgia interfering with daily tasks was reported. Ossicular reconstruction was carried out in 29 patients. Absence of cochlear toxicity was confirmed by unimpaired bone conduction. Preoperative and postoperative speech audiometry results were similar. No serious adverse events were observed. Osteointegration was satisfactory with hyperdensity or intermediate density in 95% of patients at 12 months.
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Abstract
BACKGROUND This is an update of a Cochrane review first published in The Cochrane Library (2010, Issue 7).To increase the success rate of assisted reproductive technologies (ART), adherence compounds such as hyaluronic acid (HA) and fibrin sealant have been introduced into subfertility management. Adherence compounds are added to the embryo transfer medium to increase the likelihood of embryo implantation, with the potential for higher clinical pregnancy and live birth rates. OBJECTIVES To determine whether embryo transfer media containing adherence compounds improved live birth and pregnancy rates in ART cycles. SEARCH METHODS The Menstrual Disorders and Subfertility Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE, EMBASE and PsycINFO electronic databases were searched (up to 13 November 2013) to look for publications that described randomised controlled trials on the addition of adherence compounds to embryo transfer media. Furthermore, reference lists of all obtained studies were checked, and conference abstracts were handsearched. SELECTION CRITERIA Only truly randomised controlled trials comparing embryo transfer media containing functional (e.g. 0.5 mg/ml HA) concentrations of adherence compounds versus transfer media containing low or no concentrations of adherence compounds were included. The adherence compounds that were identified for evaluation were HA and fibrin sealant. DATA COLLECTION AND ANALYSIS Two review authors selected trials for inclusion according to the above criteria, after which two review authors independently extracted the data for subsequent analysis. Statistical analysis was performed in accordance with the guidelines developed by The Cochrane Collaboration. MAIN RESULTS Seventeen studies with a total of 3898 participants were analysed. One studied fibrin sealant, and the other 16 studied HA. No evidence was found of a treatment effect of fibrin sealant as an adherence compound. For HA, evidence of a positive treatment effect was identified in the six trials that reported live birth rates (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.17 to 1.69; six RCTs, N = 1950, I(2) = 0%, moderate-quality evidence). Furthermore, the 14 trials reporting clinical pregnancy rates showed evidence of treatment benefit when embryos were transferred in media containing functional concentrations of HA (OR 1.39, 95% CI 1.21 to 1.60; 14 RCTs, N = 3452, I(2) = 46%, moderate-quality evidence) as compared with low or no use of HA. The multiple pregnancy rate (OR 1.86, 95% CI 1.49 to 2.31; five RCTs, N = 1951, I(2) = 0%, moderate-quality evidence) was significantly increased in the high HA group, but no significant differences in adverse event rates were found (OR 0.74, 95% CI 0.49 to 1.12; four RCTs, N = 1525, I(2) = 0%, moderate-quality evidence). AUTHORS' CONCLUSIONS Evidence suggests improved clinical pregnancy and live birth rates with the use of functional concentrations of HA as an adherence compound in ART cycles. However, the evidence obtained is of moderate quality. The increase in multiple pregnancy rate may be the result of use of a combination of an adherence compound and a policy of transferring more than one embryo. Further studies of adherence compounds with single embryo transfer need to be undertaken.
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Affiliation(s)
- Stephan Bontekoe
- Academic Medical Centre, University of AmsterdamCentre for Reproductive Medicine, Department of Obstetrics and GynaecologyAmsterdamNetherlands
| | - Neil Johnson
- University of AdelaideRobinson Research InstituteNorwich Centre Ground Floor, 55 King William RoadNorth AdelaideAdelaideAustralia5006
| | - Deborah Blake
- Repromed Fertility Specialists105 Remuera Rd, RemueraAucklandNew Zealand1050
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Barbizan R, Castro MV, Rodrigues AC, Barraviera B, Ferreira RS, Oliveira ALR. Motor recovery and synaptic preservation after ventral root avulsion and repair with a fibrin sealant derived from snake venom. PLoS One 2013; 8:e63260. [PMID: 23667596 PMCID: PMC3646764 DOI: 10.1371/journal.pone.0063260] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 04/01/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ventral root avulsion is an experimental model of proximal axonal injury at the central/peripheral nervous system interface that results in paralysis and poor clinical outcome after restorative surgery. Root reimplantation may decrease neuronal degeneration in such cases. We describe the use of a snake venom-derived fibrin sealant during surgical reconnection of avulsed roots at the spinal cord surface. The present work investigates the effects of this fibrin sealant on functional recovery, neuronal survival, synaptic plasticity, and glial reaction in the spinal motoneuron microenvironment after ventral root reimplantation. METHODOLOGY/PRINCIPAL FINDINGS Female Lewis rats (7 weeks old) were subjected to VRA and root replantation. The animals were divided into two groups: 1) avulsion only and 2) replanted roots with fibrin sealant derived from snake venom. Post-surgical motor performance was evaluated using the CatWalk system twice a week for 12 weeks. The rats were sacrificed 12 weeks after surgery, and their lumbar intumescences were processed for motoneuron counting and immunohistochemistry (GFAP, Iba-1 and synaptophysin antisera). Array based qRT-PCR was used to evaluate gene regulation of several neurotrophic factors and receptors as well as inflammatory related molecules. The results indicated that the root reimplantation with fibrin sealant enhanced motor recovery, preserved the synaptic covering of the motoneurons and improved neuronal survival. The replanted group did not show significant changes in microglial response compared to VRA-only. However, the astroglial reaction was significantly reduced in this group. CONCLUSIONS/SIGNIFICANCE In conclusion, the present data suggest that the repair of avulsed roots with snake venom fibrin glue at the exact point of detachment results in neuroprotection and preservation of the synaptic network at the microenvironment of the lesioned motoneurons. Also such procedure reduced the astroglial reaction and increased mRNA levels to neurotrophins and anti-inflammatory cytokines that may in turn, contribute to improving recovery of motor function.
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Affiliation(s)
- Roberta Barbizan
- Laboratory of Nerve Regeneration, Department of Structural and Functional Biology, University of Campinas - UNICAMP, Anatomy, Campinas, Brazil
| | - Mateus V. Castro
- Laboratory of Nerve Regeneration, Department of Structural and Functional Biology, University of Campinas - UNICAMP, Anatomy, Campinas, Brazil
| | | | | | | | - Alexandre L. R. Oliveira
- Laboratory of Nerve Regeneration, Department of Structural and Functional Biology, University of Campinas - UNICAMP, Anatomy, Campinas, Brazil
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Spotnitz WD. Hemostats, sealants, and adhesives: a practical guide for the surgeon. Am Surg 2012; 78:1305-1321. [PMID: 23265118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hemostats, sealants, and adhesives are useful adjuncts to modern surgical procedures. To maximize their benefit, a surgeon needs to understand the safety, efficacy, usability, and cost of these agents. To be truly added to a surgeon's own toolbox, the operator must also have knowledge of when and how to best use these materials. This commentary is designed to succinctly facilitate this understanding and knowledge. A nomenclature and classification system based on group, category, and class has been created to help with this process and is provided here. By using this system, materials consisting of similar design and for common indications can be compared. For example, in this system, the three functional groups are hemostats, sealants, and adhesives. The hemostats may be divided into four categories: mechanical, active, flowable, and fibrin sealant. These hemostat categories are further subdivided into generic classes based on the composition of the approved materials. Similarly, categories and classes are provided for sealants and adhesives. In this commentary, the salient points with respect to the characteristics of these agents are presented. A discussion of when these agents can be used in specific indications and how they may be applied to achieve the best results is also provided.
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Affiliation(s)
- William D Spotnitz
- Surgical Therapeutic Advancement Center, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
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Chaurasia SS, Champakalakshmi R, Li A, Poh R, Tan XW, Lakshminarayanan R, Lim CT, Tan DT, Mehta JS. Effect of fibrin glue on the biomechanical properties of human Descemet's membrane. PLoS One 2012; 7:e37456. [PMID: 22662156 PMCID: PMC3360777 DOI: 10.1371/journal.pone.0037456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 04/21/2012] [Indexed: 01/06/2023] Open
Abstract
Background Corneal transplantation has rapidly evolved from full-thickness penetrating keratoplasty (PK) to selective tissue corneal transplantation, where only the diseased portions of the patient's corneal tissue are replaced with healthy donor tissue. Descemet's membrane endothelial keratoplasty (DMEK) performed in patients with corneal endothelial dysfunction is one such example where only a single layer of endothelial cells with its basement membrane (10–15 µm in thickness), Descemet's membrane (DM) is replaced. It is challenging to replace this membrane due to its intrinsic property to roll in an aqueous environment. The main objective of this study was to determine the effects of fibrin glue (FG) on the biomechanical properties of DM using atomic force microscopy (AFM) and relates these properties to membrane folding propensity. Methodology/Principal Findings Fibrin glue was sprayed using the EasySpray applicator system, and the biomechanical properties of human DM were determined by AFM. We studied the changes in the “rolling up” tendency of DM by examining the changes in the elasticity and flexural rigidity after the application of FG. Surface topography was assessed using scanning electron microscopy (SEM) and AFM imaging. Treatment with FG not only stabilized and stiffened DM but also led to a significant increase in hysteresis of the glue-treated membrane. In addition, flexural or bending rigidity values also increased in FG-treated membranes. Conclusions/Significance Our results suggest that fibrin glue provides rigidity to the DM/endothelial cell complex that may aid in subsequent manipulation by maintaining tissue integrity.
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Affiliation(s)
- Shyam S. Chaurasia
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Ravi Champakalakshmi
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Ang Li
- Department of Bioengineering and Department of Mechanical Engineering, National University of Singapore, Singapore, Singapore
| | - Rebekah Poh
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Xiao Wei Tan
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | | | - Chwee T. Lim
- Department of Bioengineering and Department of Mechanical Engineering, National University of Singapore, Singapore, Singapore
- Mechanobiology Institute, Singapore, Singapore
| | - Donald T. Tan
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Singapore National Eye Centre, Singapore, Singapore
| | - Jodhbir S. Mehta
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore, Singapore
- * E-mail:
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Yoo J, Chandarana S, Fung K, Franklin JH, Nichols AC, Doyle PC. The use of autologous platelet and plasma products in salvage neck dissections: a prospective clinical study evaluating early and late wound healing. J BIOL REG HOMEOS AG 2012; 26:63S-69S. [PMID: 23648200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To evaluate the effect of autologous platelet and plasma adhesives (APA) on postoperative drainage and soft-tissue fibrosis following neck dissections. DESIGN This was a blinded comparative prospective cohort study done as two parts: part one evaluated early post-surgical outcomes and part two evaluated late tissue fibrosis. METHOD Salvage neck dissections were stratified into two groups based on severity of prior treatment. High risk patients were defined as those who had previously undergone chemoradiation therapy and autologous platelet adhesives were administered to the surgical wound intraoperatively. The low risk group consisted of patients undergoing salvage neck dissections following radiation only and acted as controls. Part one evaluated postsurgical wound drainage as the primary outcome as well as length of hospital stay and complications. Part two evaluated late postoperative tissue fibrosis by comparing neck skin using the Cutometer. R2 and F0 were the specific Cutometer parameters for quantifying the viscoelastic properties of the skin. RESULTS Postoperative wound drainage was significantly less (253.7 vs. 345.8) in the autologous platelet adhesive group as compared to the control group (p less than 0.03). Length of stay in the APA group versus the control group was 3.13 and 3.86 days respectively (p less than 0.004). Both R2 and F0 measurements showed improved viscoelastic properties of the skin in the APA group (R2 p less than 0.05, F0 p less than 0.05). CONCLUSIONS APA application following salvage neck dissections may reduce early postperative wound drainage and improve long-term skin quality.
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Affiliation(s)
- J Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
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Chauvet D, Tran V, Mutlu G, George B, Allain JM. Study of dural suture watertightness: an in vitro comparison of different sealants. Acta Neurochir (Wien) 2011; 153:2465-72. [PMID: 21989779 DOI: 10.1007/s00701-011-1197-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 09/27/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND CSF leakages constitute a major complication of intradural procedures, especially for posterior fossa and skull base surgery. Dural suture watertightness is a decisive issue, and neurosurgeons routinely use different products to reinforce their dural closure. We have designed an experimental system capable of testing CSF leak pressure levels in order to compare two types of sutures in vitro and particularly four different sealants. METHODS Twenty-five fresh human cadaveric dural samples were removed and prepared for testing in a pressure chamber system connected to a hydraulic pressure motor. CSF leak levels were objectively registered. First, simple interrupted stitches were compared to running simple closure on 50-mm linear suture. Secondly, four sealants (two sealants/glues, Bioglue®, Duraseal®; two haemostatics, Tachosil®, Tissucol®) were tested. Statistical analysis was performed with paired Student's t-test. RESULTS No significant difference between interrupted closure and running suture was observed (p = 0.079). All sealants increased the watertightness of the suture significatively. However, comparison of the means of the differences for each product revealed large variations. In the conditions of our experiment, one sealant (Duraseal®) and one haemostatic (Tachosil®) seemed to show better results. We observed two different types of leakage: at the dura-sealant interface and through the sealant itself. CONCLUSIONS We have developed an experimental device capable of testing dural closure watertightness. Interrupted stitch suturing seemed no different from running simple closure. On the contrary, the sealants tested show different watertightness capacities.
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Affiliation(s)
- Dorian Chauvet
- Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière and Lariboisiere Hospital, 29 avenue Jean Moulin, 75014 Paris, France.
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Thebaud NB, Bareille R, Remy M, Bourget C, Daculsi R, Bordenave L. Human progenitor-derived endothelial cells vs. venous endothelial cells for vascular tissue engineering: an in vitro study. J Tissue Eng Regen Med 2011; 4:473-84. [PMID: 20112278 DOI: 10.1002/term.261] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The isolation of endothelial progenitor cells from human peripheral blood generates a great hope in vascular tissue engineering because of particular benefit when compared with mature endothelial cells. We explored the capability of progenitor-derived endothelial cells (PDECs) to line fibrin and collagen scaffolds in comparison with human saphenous and umbilical cord vein endothelial cells (HSVECs and HUVECs): (a) in a static situation, allowing definition of the optimal cell culture conditions with different media and cell-seeding densities to check cell behaviour; (b) under shear stress conditions (flow chambers or tubular vascular constructs), allowing investigation of cell response and mRNA expression on both substrates by oligonucleotide microarray analysis and quantitative real-time PCR. Well characterized PDECs: (a) could not be expanded adequately with the usual mature ECs culture media; (b) were able to colonize and grow on fibrin glue; (c) exhibited higher resistance to oxidative stress than HSVECs and HUVECs; (d) withstood physiological shear stress when lining both substrates in flow chambers, and their gene expression was regulated; (e) colonized a collagen-impregnated vascular prosthesis and were able to sense mechanical forces. Our results provide an improved qualification of PDECs for vascular tissue engineering.
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Affiliation(s)
- Noélie B Thebaud
- INSERM, U577 Bordeaux, Université Victor Segalen Bordeaux 2, Bordeaux, F-33076 France
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Martinca T, Jonák M, Tonar Z, Witter K, Matejka VM, Rokosný S. [Effect of biological glues on vascular wall in an experimental model of aortic dissection]. Rozhl Chir 2011; 90:134-140. [PMID: 21638854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The use of biological glues and their application between the two dissection layers and into the anastomosis region is a common integral part of surgical management of thoracic aortic dissections. AIM The aim of the experimental study was to assess and evaluate histopathological changes of vascular wall following deposition of the following three types of glue--GRF, Tissucol, Bioglue, based on qualitative and quantitative parameters. The secondary aim of the study was to assess dynamics of these changes depending on the glue effect duration and to formulate expected behaviour of the vascular wall during the time beyond the experimental period. METHODOLOGY The dissection model was performed with pigs of the same gender and age, assigned to four groups. Different glues were used to close artificial infrarenal aortic dissections in Group 1-3, while direct suturing and no glue was used to close false lumini in Group 4. Samples of the dissected aorta were then collected at Month 1, 6 and 12 and then histologically examined. RESULTS Upon assessment of the whole group of qualitative and quantitative parameters, the most significant changes in the smooth muscle histological picture were observed with the use GRF glue. The smooth muscle changes following the Bioglue application and, in particular, Tissucol glue application, are similar to changes observed in Group 4, where no glue was used. CONCLUSION Based on the results, the authors present a hypothesis that, in a long-time horizont, vascular wall destructions, eventually redissections, are likely to occur more frequently in patients, in whom GRF glue is used.
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Affiliation(s)
- T Martinca
- Klinika kardiovaskulární chirurgie, IKEM, Praha, Ceská republika.
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Scotti C, Mangiavini L, Boschetti F, Vitari F, Domeneghini C, Fraschini G, Peretti GM. Effect of in vitro culture on a chondrocyte-fibrin glue hydrogel for cartilage repair. Knee Surg Sports Traumatol Arthrosc 2010; 18:1400-6. [PMID: 20033674 DOI: 10.1007/s00167-009-1014-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Accepted: 11/27/2009] [Indexed: 01/30/2023]
Abstract
Research in tissue engineering has been focused on articular cartilage repair for more than a decade. Some pioneristic studies involved the use of hydrogels such as alginate and fibrin glue which still possess valuable potential for cartilage regeneration. One of the main issues in cartilage tissue engineering is represented by the ideal maturation of the construct, before in vivo implantation, in order to optimize matrix quality and integration. The present study was focused on the effect of in vitro culture on a fibrin glue hydrogel embedding swine chondrocytes. We performed an evaluation of the immunohistochemical and biochemical composition and of the biomechanical properties of the construct after 1 and 5 weeks of culture. We noticed that chondrocytes survived in the fibrin glue gel and enhanced their synthetic activity. In fact, DNA content remained stable, while all indices of cartilage matrix production increased (GAGs content, immunohistochemistry for collagen II and safranin-o staining). On the other hand, the biomechanical properties remained steady, indicating a gradual substitution of the hydrogel scaffold by cartilaginous matrix. This demonstrates that an optimal preculture could provide the surgeon with a better engineered cartilage for implantation. However, whether this more mature tissue will result in a more efficient regeneration of the articular surface still has to be evaluated in future investigations.
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Affiliation(s)
- Celeste Scotti
- Residency Program in Orthopaedics and Traumatology, Gaetano Pini Orthopaedic Institute, Università degli Studi di Milano, Piazza A. Ferrari 1, 20122 Milan, Italy
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