<br>子宫骶韧带悬吊术的超分子纤维水凝胶增强治疗盆腔器官脱垂,Advanced Healthcare Materials

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子宫骶韧带悬吊术的超分子纤维水凝胶增强治疗盆腔器官脱垂
Advanced Healthcare Materials ( IF 10.0 ) Pub Date : 2023-05-23 , DOI: 10.1002/adhm.202300086
Beverly Miller ₁ , Wiley Wolfe ₂ , James L Gentry ₃ , M Gregory Grewal ₁ , Christopher B Highley _{1,

3} , Raffaella De Vita ₄ , Monique H Vaughan ₅ , Steven R Caliari _{1,

3}

Affiliation

子宫骶韧带悬吊术（USLS）是盆腔器官脱垂（POP）的常见手术治疗方法。然而，高达 40% 的相对较高的失败率凸显了临床对补充治疗策略的强烈需求，例如生物材料增强。在此，使用可注射的纤维水凝胶复合材料描述了最近建立的大鼠模型中 USLS 的第一个水凝胶生物材料增强。超分子组装的透明质酸（HA）水凝胶纳米纤维封装在基质金属蛋白酶（MMP）可降解的 HA 水凝胶中，可形成可注射支架，显示出优异的生物相容性和血液相容性。水凝胶可以成功输送并定位到 USLS 手术的缝合部位，在那里它会在六周内逐渐降解。经产 USLS 大鼠模型术后 24 周的原位力学测试显示，完整子宫骶韧带（USL）的极限负荷（失败时的负荷）为 1.70 ± 0.36 N，USLS 修复为 0.89 ± 0.28 N，USLS + 水凝胶（USLS+H）修复为 1.37 ± 0.31 N （n = 8）。这些结果表明，与标准 USLS 相比，水凝胶复合材料显着改善了组织失败所需的负荷，即使在水凝胶降解后也是如此，并且这种基于水凝胶的方法有可能降低与 USLS 程序相关的高失败率。

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Supramolecular Fibrous Hydrogel Augmentation of Uterosacral Ligament Suspension for Treatment of Pelvic Organ Prolapse

Uterosacral ligament suspension (USLS) is a common surgical treatment for pelvic organ prolapse (POP). However, the relatively high failure rate of up to 40% underscores a strong clinical need for complementary treatment strategies, such as biomaterial augmentation. Herein, the first hydrogel biomaterial augmentation of USLS in a recently established rat model is described using an injectable fibrous hydrogel composite. Supramolecularly-assembled hyaluronic acid (HA) hydrogel nanofibers encapsulated in a matrix metalloproteinase (MMP)-degradable HA hydrogel create an injectable scaffold showing excellent biocompatibility and hemocompatibility. The hydrogel can be successfully delivered and localized to the suture sites of the USLS procedure, where it gradually degrades over six weeks. In situ mechanical testing 24 weeks post-operative in the multiparous USLS rat model shows the ultimate load (load at failure) to be 1.70 ± 0.36 N for the intact uterosacral ligament (USL), 0.89 ± 0.28 N for the USLS repair, and 1.37 ± 0.31 N for the USLS + hydrogel (USLS+H) repair (n = 8). These results indicate that the hydrogel composite significantly improves load required for tissue failure compared to the standard USLS, even after the hydrogel degrades, and that this hydrogel-based approach can potentially reduce the high failure rate associated with USLS procedures.

更新日期：2023-05-23

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