Biodegradable Films in Trauma and Orthopedic Surgery

Abstract

Resorbable materials have gained a considerable position in the daily routine of all surgical disciplines. Natural products like catgut and collagen have been used historically. Since the development of synthetical macromolecules more than 40 years ago, the range of indications for the use of such materials has widened significantly in our daily routine. Suture materials, mesh, tissue pads, clips, screws and anchors are in use. More recent developments in the field of orthopedic and trauma surgery include screw-plate systems, wound dressing materials and films for the prevention of adhesions and ossifications. This appears to be the beginning of an era of new materials as these implants not only fulfil a temporary biomechanical role but in theory also can release a controlled amount of biologically active substances at a set timeframe. Also they are potential carriers for transplants on a cellular level. This aspect will be of importance in the orthopedic field, where resorbable films only play a minor role so far.At the moment there are six resorbable or biodegradable films or foils on the market that are used or can be used in the field of orthopedic and trauma surgery.These are foils and films made of following materials: carboxy-methyl-cellulose and hyaloronic acid (Seprafilm®), oxydized regenerated cellulose (Interceed®), polydioxanon (PDS®) and copolymers of lactid und caprolacton (Topkin®, Oprafol®, Mesofol®).Main indications for their use are wound dressing, especially after split skin graft and thermal wounds, prophylaxis of adhesions and prevention of the formation of synostoses and heterotopic ossifications. The results of clinical trials are promising and the increasing number of publications in the last 5 years in this field is an expression of increasing demand of these materials. However, it could also be an expression of the growing interest in drug delivery techniques as well as in tissue engineering which are possible with these materials.

Antibiotic-eluting bioresorbable composite fibers for wound healing applications: Microstructure, drug delivery and mechanical properties

“…Bioresorbable dressings successfully address this shortcoming, since they do not need to be removed from the wound surface once they have fulfilled their role. Film dressings made of lactide-caprolactone copolymers such as Topkin Ò (Biomet, Europe) and Oprafol Ò (Lohmann & Rauscher, Germany) are currently available [4]. Biodegradation of these films occurs via hydrolysis of the copolymer into lactic acid and 6-hydroxycaproic acid.…”

Controlled Delivery of Gentamicin Antibiotic from Bioactive Electrospun Polylactide‐Based Ultrathin Fibers

“…Wound healing currently not only aims to restore the milieu required for tissue regeneration but also to protect the wound from environmental threats and penetration of bacteria. Novel bioresorbable wound dressings successfully avoid clinical replacement since they do not need to be removed from the wound surface once they have fulfilled their role 1…”

Chitin membrane for wound dressing application – preparation, characterisation and toxicological evaluation

“…An ideal dressing should be able to be removed without inducing trauma during dressing change over healed areas in the wound bed. Resorbable materials are gaining considerable importance in all surgical disciplines and also for use as wound dressing (23). Physical and biological characterisation of the chitin membranes has shown that the membranes have ideal properties for a dressing and thus would aid in maintenance of a balanced moist wound environment to structural support for tissue regeneration.…”

“…Counts/100 cm sq. Counts/g (23). Physical and biological characterisation of the chitin membranes has shown that the membranes have ideal properties for a dressing and thus would aid in maintenance of a balanced moist wound environment to structural support for tissue regeneration.…”