Design of an injectable synthetic and biodegradable surgical biomaterial

Abstract

We report the design of an injectable synthetic and biodegradable polymeric biomaterial comprised of polyethylene glycol and a polycarbonate of dihydroxyacetone (MPEG-pDHA). MPEG-pDHA is a thixotropic physically cross-linked hydrogel, displays rapid chain relaxation, is easily extruded through narrow-gauge needles, biodegrades into inert products, and is well tolerated by soft tissues. We demonstrate the clinical utility of MPEG-pDHA in the prevention of seroma, a common postoperative complication following ablative and reconstructive surgeries, in an animal model of radical breast mastectomy. This polymer holds significant promise for clinical applicability in a host of surgical procedures ranging from cosmetic surgery to cancer resection.hydrogel | seroma prevention | dihydroxyacetone | surgical biomaterial P olymeric biomaterials have contributed significantly to the advancement of medical and surgical practice over the past few decades. Their macromolecular structure can be tailored to provide the appropriate combination of chemical, physical, and biological properties necessary for a range of medical and surgical applications. The rational design of polymeric biomaterials has impacted many fields, including drug and gene delivery, orthopedics, tissue engineering, ophthalmology, and general surgery (1-3). The work reported herein focuses on the development of an injectable surgical biomaterial. Its potential impact is demonstrated in the prevention of postoperative seroma.A seroma is an abnormal collection of serous fluid within the tissues of the body, akin to an internal blister. Seroma formation is a common postoperative complication particularly following ablative and reconstructive surgeries. Surgeries that require extensive tissue dissection and create large empty spaces can disrupt normal lymphatic flow. Subsequently, transduate fluid collects in these poorly drained "dead spaces," resulting in formation of a seroma (4, 5). Seromas can lead to significant patient morbidity, such as infection, decreased limb mobility, and reoperation (4, 6, 7). Seroma formation rates range from 9.1% to 81%, depending on the nature of the surgical procedure (6,(8)(9)(10)(11)(12)(13). Notably, modified radical mastectomies lead to seroma formation rates ranging from 15% to 38.6%, and radical mastectomies report a rate as high as 52% (7,(14)(15)(16)(17). In current clinical practice, silicone surgical drains are placed in the wound bed through separate stab incisions to collect transudate fluid, but they can be a significant source of pain and discomfort to patients, especially upon their removal up to several weeks after the initial surgical procedure. Furthermore, they can increase the risk of infection at the surgical site.Several approaches to reduce seroma formation have been investigated. Surgical techniques, such as collapsing the seroma cavity with sutures, do not consistently and adequately eliminate seroma formation (16,18,19). Other methods, such as sclerotherapy (20, 21), compression dressings (22), and biolog...

Poly(carbonate-ester)s of Dihydroxyacetone and Lactic Acid as Potential Biomaterials

“…10,12,27 To eliminate the possibility of ester hydrolysis from the reaction conditions present in a trifluoroacetic acid-water deprotection, a deprotection catalyzed by molecular iodine in acetone was investigated. 28 With this method, the degree of deprotection was directly correlated to the molar ratio of LA and DHA within the copolymer.…”

Biomaterials for Integration with 3-D Bioprinting

“…Rather, these materials have been investigated as delivery vehicles of drugs or cells for in situ injection. 46,67,88 Temperature Influence and Control Temperature can come into play during bioprinting in several ways. First and foremost, as described above, some biomaterials require elevated temperatures in order to be printed.…”

Synthetic Biomaterials from Metabolically Derived Synthons

“…It is hypothesized that the transient nature of such attractions contribute to the ability to extrude MPEG-pDHA through a 26-gauge needle (Figure 16b). 179 …”

“…(c) Seroma volumes measured using a rat mastectomy model following treatment with various MPEG-pDHA formulations and a saline control. Figures are reprinted from ref 179 with permission. Copyright 2010 National Academy of Sciences, USA.…”