Ultrasound Imaging and Treatment of Hernia Mesh

迫切需要开发一种新的装置来非侵入性地治疗网状物感染，而不去除网状物。 网格在没有这种装置的情况下，许多网状物感染的治疗将仍然是高度侵入性的， 很贵。本研究的目的是开发基于空化的组织破坏术来治疗外科补片感染。 组织摧毁术在组织中产生/激发微米大小的气泡云，其机械地撕碎靶向组织。 细胞微泡塌陷的物理学促进了附着在植入物上的细菌的溶解，从而增强了植入物的生物相容性。 破坏引起感染的细菌生物膜。 具体目标#1：改进脉冲方案，以减少空化记忆的影响。我们假设 在我们的应用中，增加较低幅度的脉冲将减少空化记忆， 治疗时间。还将确定不同的暴露对补片性能的影响。 暴露条件。 具体目标#2：提高补片对比度。我们假设，如果我们 联合收割机组合剪切波和脉冲回波成像和/或通过添加玻璃微球来增加网格对比度， 聚丙烯纤维。增加对比度还可以通过提供 离开网格的更强的反射增加了网格附近的压力场。 具体目标#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处理疝补片上的细菌生物膜。这 将通过在猪模型的不同植入位置植入受感染的补片样本来评价假设 和深度，同时还仔细评估组织的任何意外损伤。 这个项目意义重大，因为一旦开发，每年将有成千上万的患者有一个替代方案。 涉及用于治疗网状物感染的侵入性手术。此外，改善补片对比度可以改善患者护理 即使没有感染一旦证明了补片感染的可行性， 植入的装置可能是我们相同的基于组织病理学的治疗的候选者。

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.