development-benchtop-model-for-evaluating-compatibility-wound

Development of a Benchtop Model for Evaluating the Compatibility of Wound Dressing Materials with Negative Pressure Wound Therapy Systems

Negative pressure wound therapy (NPWT) systems facilitate wound healing by applying sub-atmospheric pressure to the wound bed, which promotes granulation ...

University of Memphis-University of Tennessee Health Science Center

Much research is directed at surface modifications to enhance osseointegration of implants. A new potential coating is the biopolymer, chitosan, the deacetylated derivative of the natural polysaccharide, chitin. Chitosan is biocompatible, degradable, nontoxic, and exhibits osteogenic properties. The aim of this research was to investigate the hypothesis that chitosan-coated titanium supports bone formation and osseointegration.

The integration of chitosan-coated titanium in bone: an in vivo study in rabbits.

Treatment for compound and/or comminuted fractures is frequently accomplished via external fixation. To achieve stability, the compositions of external fixators generally include aluminum alloy components due to their high strength-to-weight ratios. These alloys are particularly susceptible to corrosion in chloride environments. There have been several clinical cases of fixator failure in which corrosion was cited as a potential mechanism. The aim of this study was to evaluate the effects of physiological environments on the corrosion susceptibility of aluminum 7075-T6, since it is used in orthopedic external fixation devices. Electrochemical corrosion curves and alternate immersion stress corrosion cracking tests indicated aluminum 7075-T6 is susceptible to corrosive attack when placed in physiological environments. Pit initiated stress corrosion cracking was the primary form of alloy corrosion, and subsequent fracture, in this study. Anodization of the alloy provided a protective layer, but also caused a decrease in passivity ranges. These data suggest that once the anodization layer is disrupted, accelerated corrosion processes occur.

Stress corrosion cracking of an aluminum alloy used in external fixation devices.

Dental implants have 89% plus survival rates at 10-15 years, but peri-implantitis or dental implant infections may be as high as 14%. Peri-implantitis can limit clinical success and impose health and financial burdens to patients and health providers. The pathogenic species associated with periodontitis (e.g., Fusobacterium ssp, A. actinomycetemcomitans, P. gingivalis) are also associated with peri-implantitis. Incidence of peri-implantitis is highest within the first 12 months after implantation, and is higher in patients who smoke or have poor oral health as well as with calcium-phosphate-coated or surface-roughened implants. Biomaterial therapies using fibers, gels, and beads to deliver antibiotics have been used in the treatment of Peri-implantitis though clinical efficacy is not well documented. Guided tissue regeneration membranes (e.g., collagen, poly-lactic/glycolic acid, chitosan, ePTFE) loaded with antimicrobials have shown success in reosseointegrating infected implants in animal models but have not been proven in humans. Experimental approaches include the development of anti-bioadhesion coatings, coating surfaces with antimicrobial agents (e.g., vancomycin, Ag, Zn) or antimicrobial releasing coatings (e.g., calcium phosphate, polylactic acid, chitosan). Future strategies include the development of surfaces that become antibacterial in response to infection, and improvements in the permucosal seal. Research is still needed to identify strategies to prevent bacterial attachment and enhance normal cell/tissue attachment to implant surfaces.

Biomaterial and antibiotic strategies for peri-implantitis: a review.

Peri-implantitis is an inflammatory disease due to bacteria and plaque formation on implant surfaces which can lead to bone resorption and loss of osseointegration. Biomaterial strategies to prevent or eliminate initial bacterial attachment, in favor of host tissue attachment may have a positive effect on decreasing peri-implantitis, particularly for at risk patient groups. This study provides a brief overview of some of the experimental biomaterial strategies aimed at suppressing or inhibiting bacterial colonization of implant surfaces in favor or host cells and tissues.

Emerging antibacterial biomaterial strategies for the prevention of peri-implant inflammatory diseases.

Composite chitosan-nano-hydroxyapatite microspheres and scaffolds prepared using a co-precipitation method have shown potential for use in bone regeneration. The goal of this research was to improve the functional properties of the composite scaffolds by modifying the fabrication parameters. The effects of degree of deacetylation (DDA), drying method, hydroxyapatite content and an acid wash on scaffold properties were investigated. Freeze-dried 61% DDA scaffolds degraded faster (3.5 ± 0.5% mass loss) than air-dried 61% DDA scaffolds and 80% DDA scaffolds, but had a lower compressive modulus of 0.12 ± 0.01 MPa. Air-dried 80% DDA scaffolds displayed the highest compressive modulus (3.79 ± 0.51 MPa) and these scaffolds were chosen as the best candidate for use in bone regeneration. Increasing the amount of hydroxyapatite in the air-dried 80% DDA scaffolds did not further increase the compressive modulus of the scaffolds. An acid wash procedure at pH 6.1 was found to increase the degradation of air-dried 80% DDA scaffolds from 1.3 ± 0.1% to 4.4 ± 0.4%. All of the formulations tested supported the proliferation of SAOS-2 cells.

Preparation and functional assessment of composite chitosan-nano-hydroxyapatite scaffolds for bone regeneration.

The objective of this study was to evaluate the osteoinductivity of composite chitosan-nano-hydroxyapatite scaffolds in a rat muscle pouch model. Previous in vitro characterization demonstrated the ability of the scaffolds to promote bone regeneration and as a carrier for local delivery of BMP-2. Composite microspheres were prepared using a co-precipitation method, and scaffolds were fabricated using an acid wash to adhere beads together. To determine the in vivo osteoinductivity of the scaffolds, the following groups (n = 6) were implanted into muscle pouches created in the latissimus dorsi of Sprague Dawley rats: (A) lyophilized scaffolds without rhBMP-2, (B) lyophilized scaffolds with rhBMP-2, (C) non-lyophilized scaffolds with rhBMP-2, and (D) absorbable collagen sponge with rhBMP-2 (control). Groups B, C, and D were loaded with 4 mL of a 9.0 μg/mL solution of rhBMP-2 for 48 h. The rats were sacrificed after one month and samples were analyzed for amount of residual implant material, new bone, and osteoid. Although the experimental groups displayed minimal degradation after one month, all of the scaffolds contained small amounts of woven bone and considerable amounts of osteoid. Approximately thirty percent of the open space available for tissue ingrowth in the scaffolds contained new bone or osteoid in the process of mineralization. The ability of the composite scaffolds (with and without BMP-2) to promote ectopic bone growth in vivo was demonstrated.

Osteoinductivity Assessment of BMP-2 Loaded Composite Chitosan-Nano-Hydroxyapatite Scaffolds in a Rat Muscle Pouch.

Degree of deacetylation (DDA) and molecular weight (MW) of chitosans are important to their physical and biological properties. In this study, two chitosans, HS (DDA = 73.3%) and AT (DDA = 76.8%), were deacetylated with 45% sodium hydroxide under nitrogen atmosphere at 80 °C or 90 °C for up to 120 min, to obtain two series of chitosans. The polymers produced were characterized for MW by gel permeation chromatography, DDA by titration and UV-vis methods, and crystallinity, hydrophilicity and thermal stability by X-ray diffraction, water contact angle and differential scanning calorimetry respectively. Films, made by solution casting in dilute acetic acid at ambient conditions, were evaluated for biological activity by albumin adsorption and the attachment and growth of a pre-osteoblast cell line. Chitosans with between 80-93% DDA's (based on titration) were reproducibly obtained. Even though deacetylation under nitrogen was supposed to limit chain degradation during decetylation, MW decreased (by maximum of 37.4% of HS and 63.0% for AT) with increasing deacetylation reaction time and temperature. Crystallinity and decomposition temperature increased and water contact angles decreased with processing to increase DDA. Significantly less albumin was absorbed on films made with 93% DDA chitosans as compared with the original materials and the AT chitosans absorbed less than the HS chitosans. The cells on higher DDA chitosan films grew faster than those on lower DDA films. In conclusion, processing conditions increased DDA and influenced physicochemical and biological properties. However, additional studies are needed to unambiguously determine the influence of DDA or MW on in vitro and in vivo performance of chitosan materials for bone/implant applications.

Deacetylation of Chitosan: Material Characterization and in vitro Evaluation via Albumin Adsorption and Pre-Osteoblastic Cell Cultures.

Complex open musculoskeletal wounds are a leading cause of morbidity worldwide, partially due to a high risk of bacterial contamination. Local delivery systems may be used as adjunctive therapies to prevent infection, but they may be nondegradable, possess inadequate wound coverage, or migrate from the wound site. To address this issue, a thermo-responsive, injectable chitosan paste was fabricated by incorporating beta-glycerophosphate. The efficacy of thermo-paste as an adjunctive infection prevention tool was evaluated in terms of cytocompatibility, degradation, antibacterial, injectability, and inflammation properties. In vitro studies demonstrated thermo-paste may be loaded with amikacin and vancomycin and release inhibitory levels for at least 3 days. Further, approximately 60% of thermo-paste was enzymatically degraded within 7 days in vitro. The viability of cells exposed to thermo-paste exceeded ISO 10993-5 standards with approximately 73% relative viability of a control chitosan sponge. The ejection force of thermo-paste, approximately 20 N, was lower than previously studied paste formulations and within relevant clinical ejection force ranges. An in vivo murine biocompatibility study demonstrated that thermo-paste induced minimal inflammation after implantation for 7 days, similar to previously developed chitosan pastes. Results from these preliminary preclinical studies indicate that thermo-paste shows promise for further development as an antibiotic delivery system for infection prevention.

Development and Evaluation of an Injectable Chitosan/β-Glycerophosphate Paste as a Local Antibiotic Delivery System for Trauma Care.

Electrospun chitosan membranes subjected to post-spinning processes using either triethylamine/tert-butyloxycarbonyl (TEA/tBOC) or butyryl-anhydride (BA) modifications to maintain nanofiber structure have exhibited potential for use in guided bone regeneration applications. The aim of this study was to evaluate ability of the modified membranes to support healing of bone-grafted defects as compared to a commercial collagen membrane.

Article	Year
The integration of chitosan-coated titanium in bone: an in vivo study in rabbits. Implant dentistry\| PubMed ID: 17356373	2007
Stress corrosion cracking of an aluminum alloy used in external fixation devices. Journal of biomedical materials research. Part B, Applied biomaterials\| PubMed ID: 18257055	2008
Biomaterial and antibiotic strategies for peri-implantitis: a review. Journal of biomedical materials research. Part B, Applied biomaterials\| PubMed ID: 18698626	2009
Emerging antibacterial biomaterial strategies for the prevention of peri-implant inflammatory diseases. The International journal of oral & maxillofacial implants\| PubMed ID: 21691602	2011
Preparation and functional assessment of composite chitosan-nano-hydroxyapatite scaffolds for bone regeneration. Journal of functional biomaterials\| PubMed ID: 24956519	2012
Osteoinductivity Assessment of BMP-2 Loaded Composite Chitosan-Nano-Hydroxyapatite Scaffolds in a Rat Muscle Pouch. Materials (Basel, Switzerland)\| PubMed ID: 28824147	2011
Deacetylation of Chitosan: Material Characterization and in vitro Evaluation via Albumin Adsorption and Pre-Osteoblastic Cell Cultures. Materials (Basel, Switzerland)\| PubMed ID: 28824150	2011
Development and Evaluation of an Injectable Chitosan/β-Glycerophosphate Paste as a Local Antibiotic Delivery System for Trauma Care. Journal of functional biomaterials\| PubMed ID: 30322006	2018
A comparison of two types of electrospun chitosan membranes and a collagen membrane in vivo. Dental materials : official publication of the Academy of Dental Materials\| PubMed ID: 33208266	2021

Joel D. Bumgardner

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