Bioadhesive Membrane Construct for Hernia Repair

描述（由申请人提供）：当内脏器官的一部分通过肌肉的薄弱区域凸出时，发生疝，大多数疝发生在腹部。手术疝修补术是美国最常见的手术之一。虽然使用假体补片作为加固物显著改善了手术结局，但疝复发率仍然很高（30-50%）。目前的假体材料与许多并发症相关，包括感染风险增加、假体收缩和宿主-异物反应，导致术后患者生活质量下降。最近引入的各种生物假体补片来源于改良的人或猪组织，与其合成对应物相比，其感染率较低。同样重要的是，补片对腹壁的有效固定对于疝修补术的成功至关重要。目前，缝线和斯台普斯用于将合成和生物补片固定到位，但这些可能是神经损伤和慢性不适的来源。因此，仍然需要开发替代的固定方法，其可以有效地将网片固定到腹壁上，并改善这些网片的长期生物相容性。海洋贻贝为该提案中提出的新技术提供了灵感。通过释放快速硬化、紧密结合的粘附蛋白，海洋贻贝具有在潮湿、湍流和盐水环境中将自身锚到各种表面的能力。天然蛋白质和它们的合成模拟物都可以与从生物组织到金属表面的各种基质强烈结合。在这项提案中，仿生合成粘合剂将与天然支架结合，以创造一种新型的生物粘附假体。这种结构的目的是创建有效的修复，最大限度地减少长期感染率和通常与永久性假体材料相关的慢性患者不适。将测试使用这种材料进行疝修补的可行性。公共卫生相关性疝修补术用生物粘附膜结构疝修补术是美国最常进行的外科手术之一。目前的修复方法和材料表现出混合的成功，但每一个都有局限性，如高复发率和持续的患者不适。本文描述了一种用于疝修补术的新型生物粘附膜结构的开发和评价。

DESCRIPTION (provided by applicant): A hernia occurs when part of an internal organ bulges through a weak area of muscle, with most hernias occurring in the abdomen. Surgical hernia repair is one of the most commonly performed surgeries in the US. While using prosthetic mesh as a reinforcement has significantly improved surgical outcomes, the rate of hernia recurrence remains high (30-50%). Current prosthetic materials are associated with numerous complications, including increased risk of infection, prosthetic shrinkage and host-foreign body reactions, leading to a diminished postoperative patient quality of life. The recent introduction of various biologic prosthetic meshes derived from modified human or porcine tissue have demonstrated lower rates of infection as compared to their synthetic counterparts. Equally important, effective immobilization of the mesh against the abdominal wall is critical to hernia repair success. Currently, sutures and staples are used to hold synthetic and biologic meshes in place, but these can be a source of nerve damage and chronic discomfort. Thus, there continues to be a need to develop alternative fixation methods that can effectively secure the mesh to the abdominal wall as well as improve long- term biocompatibility of these meshes. Marine mussels provided the inspiration for the new technology presented in this proposal. By releasing rapidly hardening, tightly binding adhesive proteins, marine mussels have the ability to anchor themselves to various surfaces in a wet, turbulent, and saline environment. Both natural proteins and their synthetic mimics can bind strongly to various substrates ranging from biological tissues to metal surfaces. In this proposal, biomimetic synthetic adhesives will be combined with a natural scaffold to create a novel bioadhesive prosthetic. The intent of such a construct is to create an effective repair with minimized long-term infection rate and chronic patient discomfort typically associated with permanent prosthetic materials. The feasibility of using such a material for hernia repair will be tested. PUBLIC HEALTH RELEVANCE Bioadhesive Membrane Construct for Hernia Repair Hernia repair is one of the most frequently performed surgical procedures in the United States. Current repair methods and materials have exhibited mixed success, but each has limitations such as high recurrence rate and persistent patient discomfort. The development and evaluation of a novel bioadhesive membrane construct for hernia repair is described here.