Biomimetic coatings and negative pressure wound therapy independently limit epithelial downgrowth around percutaneous de
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ENGINEERING AND NANO-ENGINEERING APPROACHES FOR MEDICAL DEVICES Original Research
Biomimetic coatings and negative pressure wound therapy independently limit epithelial downgrowth around percutaneous devices Sujee Jeyapalina
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Saranne J. Mitchell1,3,4 Jayant Agarwal2 Kent N. Bachus1,3,4 ●
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Received: 26 September 2018 / Accepted: 25 May 2019 / Published online: 10 June 2019 © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019
Abstract Biomimetic material coatings and negative pressure wound therapy (NPWT) have been shown independently to limit the epithelial downgrowth rates in percutaneous devices. It was therefore hypothesized that these techniques, in combination, could further limit the clinically observed epithelial downgrowth around these devices. In this study, we evaluated the efficacy of two biomimetic coatings, collagen and hydroxyapatite (HA), to prevent downgrowth when used with continuous NPWT. Using an established single-stage surgical protocol, collagen (n = 10) and HA (n = 10) coated devices were implanted subdermally on the back of hairless guinea pigs. Five animals from each group were subjected to continuous ~90 mmHg NPWT. Four weeks post-implantation, animals were sacrificed, and the devices and surrounding tissues were harvested, processed, and downgrowth was computed and compared to historical porous titanium coated controls. Data showed a significant reduction in downgrowth in NPWT treated animals (p ≤ 0.05) when compared to the untreated porous titanium controls. HA coated devices, without the NPWT treatment, also showed significantly decreased downgrowth compared to the untreated porous titanium controls.
* Sujee Jeyapalina [email protected]
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* Kent N. Bachus [email protected]
Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA
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Department of Bioengineering, University of Utah Salt Lake City, Salt Lake City, UT 84112, USA
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Department of Veterans Affairs Medical Center, Orthopaedic Research Laboratory, Salt Lake City, UT 84148, USA
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1 Introduction Percutaneous devices, both temporary and permanent, are increasingly common in modern medicine. One such application is the attachment of artificial exoprosthesis through a percutaneous osseointegrated (OI) docking system. However, wider use of these percutaneous OI devices is restricted partially due to the high rates of clinically reported infections of the stoma around the percutaneous device: both superficial and/or chronic. Rates as high as 18–54% were reported in human clinical trials [1–4]. These high infection rates often lead to chronic antibiotic use and eventual revision surgeries [1–4]: often at a substantial cost to both the patients, and the healthcare system. Surgical contamination, poor bone integration, a
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