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Robust closure of post-endoscopic submucosal dissection perforation by microparticle-based wound dressing
Biomaterials Advances ( IF 7.9 ) Pub Date : 2021-02-24 , DOI: 10.1016/j.msec.2021.111993
Shima Ito , Akihiro Nishiguchi , Fumisato Sasaki , Hidehito Maeda , Masayuki Kabayama , Akio Ido , Tetsushi Taguchi

Endoscopic submucosal dissection (ESD) has been used as a minimally invasive cancer treatment for early-stage gastrointestinal cancer. However, cancer dissection in thin tissues, such as the duodenum and large intestine, often cause post-ESD and delayed perforation, which elicit severe complications. In this study, we report a microparticle-based wound dressing with hydrophobically-modified gelatin that can close the perforation after ESD. Hydrophobized microparticles were prepared using a coacervation method in a water/ethanol mixed solvent. The optimized alkyl chain length and degree of substitution of hydrophobic groups improved the mechanical strength of the hydrogel formed by hydration and fusion of the microparticles. The hydrogels formed on tissue defects revealed higher burst strength in ex vitro perforation models using duodenum, large intestine, and stomach under wet conditions compared with hydrogels without hydrophobic modification. The particle fusion was determined to be a crucial step to yield a high burst strength. An in vivo degradability evaluation showed that microparticle hydrogels subcutaneously implanted in rats degraded within 14 days. The microparticle wound dressing is expected to be applicable to post-ESD perforation and prevent delayed perforation.



中文翻译:

内窥镜后黏膜下剥离穿孔通过基于微粒的伤口敷料稳固闭合

内镜黏膜下剥离术(ESD)已被用作早期胃肠道癌的微创癌症治疗方法。然而,在诸如十二指肠和大肠之类的薄组织中进行癌症解剖常常会导致ESD后和穿孔延迟,从而引发严重的并发症。在这项研究中,我们报告了一种基于微粒的伤口敷料,该敷料具有疏水改性的明胶,可在ESD后闭合穿孔。使用凝聚法在水/乙醇混合溶剂中制备疏水化的微粒。优化的烷基链长度和疏水基团的取代度改善了通过微粒的水合和融合形成的水凝胶的机械强度。在组织缺陷上形成的水凝胶在使用十二指肠的体外穿孔模型中显示出更高的破裂强度,与未经疏水改性的水凝胶相比,在潮湿条件下的大肠和胃。确定粒子融合是产生高破裂强度的关键步骤。体内可降解性评估表明,皮下植入大鼠的微粒水凝胶在14天内降解。预计微粒伤口敷料可用于ESD后穿孔,并防止延迟穿孔。

更新日期:2021-02-28
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