水性可降解聚胺酯用於預防肌腱術後沾黏之評估

Abstract

肌腱沾黏目前仍是一個嚴重的問題,主要是因為它會影響肌腱的滑翔與關節 活動,雖然現在有許多研究著重於抗沾黏材料,但仍有許多問題,尤其是臨床化 的使用。聚胺酯是一個具有好機械強度與生物相容性之材料,有在抗沾黏使用上 的潛力,在本次研究中,一系列不同離子強度的聚胺酯被合成,之後進行物理化 學性質與生物相容性之分析,之後會選擇最適當的聚胺酯進行兔動物肌腱損傷模 型。 合成的一系列聚胺酯皆無生物毒性且不影響細胞型態,並且有適當的機械性 質與親疏水性,在膠體附著測試上聚胺酯比聚己內酯更不容易附著,這指出胞外 基質不容易沉積在聚胺酯上,動物肌腱損傷模型顯現聚胺酯有良好的抗沾黏效果, 明顯優於聚己內酯與不使用抗沾黏膜,並略優於商業抗沾黏膜,並且不會影響肌腱回復。

Tendon adhesion has been a serious problem and it affects the tendon gliding and joint motion. Although recent studies have yielded promising results in developing anti-adhesion materials, there are still many problems, especially in clinical applications. Polycaprolactone (PCL)-based Polyurethane (PU) has good mechanical properties and biocompatibility, and it has a potential in anti-adhesion applications. In this study, a series of PUs with different ratios of ionic groups were synthesized. The PU films were cast and characterized for physico-chemical properties and biocompatibility. The most appropriate one was selected for animal studies and implanted to the tendons of the rabbits. All PU films were non-cytotoxic to cells and had mechanical properties suitable for anti-adhesion applications of the tendon surgery. Meanwhile, PU films demonstrated a lower peeling energy than the PCL film by the gelatin test, indicating that gelatin or extracellular matrix may not be easily deposited on the PUs. The rabbit implantation showed that PU had better anti-adhesion effect than PCL films and the untreated control, and demonstrated no significant difference in the anti-adhesion performance from the commercial product Seprafilm.