Ultrasound Imaging and Treatment of Hernia Mesh

疝气补片的超声成像和治疗

• 批准号: 10655885
• 负责人: Timothy Allen Bigelow
• 金额: $ 48.84万
• 依托单位: IOWA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655885
• 关键词: Animal Model; Antibiotics; Bacteria; Cells; Clinical; Cytolysis; Devices; Effectiveness; Fiber; Future; Glass; Goals; Grant; Hernia; Human; Image; Image-Guided Surgery; Implant; In Vitro; Infection; Length of Stay; Lesion; Location; Mechanics; Memory; Microbial Biofilms; Microbubbles; Microspheres; Operative Surgical Procedures; Patient Care; Patients; Performance; Physics; Physiologic pulse; Polypropylenes; Process; Property; Public Health; Recurrence; Research; Safety; Sampling; Scheme; Surgical Mesh; Surgical incisions; Testing; Time; Tissues; Transducers; Ultrasonography; United States National Institutes of Health; Visualization; Work; contrast imaging; cost; design; experimental study; implantable device; improved; in vivo; medical implant; porcine model; pressure; prevent; repaired; targeted treatment; therapy development; tool; ultrasound

There is a critical need to develop a new device to noninvasively treat mesh infections without removing the mesh. In the absence of such a device, the treatment of many mesh infections will remain highly invasive and costly. This study's objective is to develop cavitation-based histotripsy to treat surgical mesh infections. Histotripsy generates/excites a cloud of micron sized bubbles in the tissue which mechanically shred the targeted cells. The physics of microbubble collapse promotes lysis of bacteria attached to the implant enhancing the destruction of the bacteria biofilm causing the infection. Specific Aim #1: Improve pulsing scheme to reduce the impact of cavitation memory. We hypothesize that adding lower amplitude pulses will reduce cavitation memory in our application as well drastically reducing treatment times. The impact of the exposures on mesh properties will also be determined for the different exposure conditions. Specific Aim #2: Improve mesh Contrast. We hypothesize that it will be easier to visualize the mesh if we combine shear-wave and pulse echo imaging and/or increase mesh contrast by adding glass microspheres to the polypropylene fibers. Increasing the contrast may also increase the effectiveness of our therapy by providing a stronger reflection off the mesh increasing the pressure fields in the immediate vicinity of the mesh. Specific Aim #3: Test therapies safety and effectiveness in an animal model. We hypothesize that our therapy will be able to treat bacteria biofilms on hernia mesh safely and effectively in an animal model. This hypothesis will be evaluated by implanting infected mesh samples in a swine model at varying implant locations and depths while also carefully assessing the tissue for any unintended damage. This project is significant because once developed thousands of patients each year would have an alternative to invasive surgery for treating mesh infections. In addition, improving mesh contrast could improve patient care even when no infection develops. Once feasibility has been shown for mesh infections, numerous other implanted devices may be candidates for our same histotripsy-based treatment.

迫切需要开发一种新设备，以无创治疗网格感染而无需去除 网。在没有这种设备的情况下，许多网格感染的治疗将保持高度侵入性，并且 昂贵。这项研究的目的是开发基于空化的组织疗法以治疗手术网格感染。 组织疗法在组织中产生/激发一团微米大小的气泡，该云机械切碎了靶向 细胞。微泡塌陷的物理学促进了附着在植入物上的细菌的裂解，从而增强了 破坏了引起感染的细菌生物膜。 特定目的＃1：改善脉冲方案以减少空化记忆的影响。我们假设这一点 添加较低的振幅脉冲将减少我们应用中的空化记忆，并大大降低 治疗时间。还将确定暴露对网格特性的影响 暴露条件。 特定目标＃2：改善网格对比度。我们假设如果我们 通过将玻璃微球添加到 聚丙烯纤维。增加对比度也可能通过提供来提高我们治疗的有效性 在网格附近增加压力场的网眼的反射更强。 特定目的＃3：在动物模型中测试疗法的安全性和有效性。我们假设我们的 治疗将能够在动物模型中安全有效地治疗疝网上的细菌生物膜。这 假设将通过在不同植入物位置将受感染的网状样品植入猪模型中来评估 和深度，同时还要仔细评估任何意外损害的组织。 该项目很重要，因为每年曾经成千上万的患者有替代 用于治疗网格感染的侵入性手术。此外，改善网格对比可以改善患者护理 即使没有感染。一旦显示了网格感染的可行性， 植入的设备可能是我们基于组织疗法的治疗方法的候选者。