Ultrasound Imaging and Treatment of Hernia Mesh

迫切需要开发一种新的设备来无创地治疗网状物感染，而不需要移除

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.