開發緩釋血小板濃縮液之水膠套件以促進肌腱韌帶組織術後之癒合

Abstract

目前在臨床上，前十字韌帶 (Anterior Cruciate Ligament, ACL) 斷裂常利用重建手術來修復，主要是將病人自體的髕骨肌腱或後腿肌腱取代受傷之組織。然而手術時並無法修復受損的血管，因此組織會長期處於低氧氣及低養分的環境中，使得術後修復的時間及癒合效果都會受到影響。也因為這樣目前有許多研究常常會使用生物活性物質（例如：血小板濃厚液 (platelet-rich plasma, PRP）)來促進前十字韌帶修復。 血小板濃厚液 (platelet-rich plasma, PRP) 是一種富含多種生長因子、蛋白質等物質，常用於刺激骨骼、軟骨、韌帶、肌腱、肌肉等組織再生，可利用其特質來加速前十字韌帶斷裂術後修復的癒合。 PRP容易因為其高流動性，而無法在注射於患部時長時間的停留在人體內。若是能夠利用水膠交聯系統，將PRP包覆在內並延長其停留在體內的時間，來達到緩慢釋放的效果。除此之外，為了能夠使水膠和PRP在手術中簡便的混合製備，將會設計一混合裝置使其能於單一系統中混合均勻，並且能將製備好的水膠直接置於病人體內，以達到緩慢釋放PRP來修復傷口。

Currently in clinical, Anterior Cruciate Ligament (ACL) reconstruction surgery often replaces the injured tissue by using patient's own iliac tendon or hind leg tendon. However, due to the surgery are without the blood vessel repairment, tissues might have a long-term exposure to low-oxygen and low-nutrient after surgery, therefore, the repair time and healing will be affected. It is why there are many researches about using bioactive substances such as Platelet-Rich-Plasma (PRP) to enhance ACL healing. PRP is rich in a variety of growth factors (GFs), proteins and other substances, and it’s often used to stimulate bone, cartilage, ligament, tendon, muscle and other tissue regeneration. It is therefore expected to accelerate the healing of the ACL after its rupture. However, due to the high fluidity of PRP, it is hard to stay in the body for a long time when inject into the affected part. If the PRP can be encapsulated into the hydrogel by cross-linking, the retention time of PRP in the body's may also be prolonging. Therefore, the healing of ACL can also be enhanced through slow release PRP when use PRP treatment after surgery. In addition, in order to easily prepare PRP and hydrogel in one system during the surgery, we design a mixing device that can directly place the PRP hydrogel which is already mixed into the patient and slow release PRP for repairing wound.