Development of a new surgical sheet containing both silk fibroin and thermoplastic polyurethane for cardiovascular surgery
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The surgical sheets that are currently used for congenital cardiovascular surgery have several drawbacks, including material deterioration, calcification, and pseudo-intimal proliferation resulting in hemodynamic disturbance. The aim of this study was to evaluate a newly developed sheet made from a combination of silk fibroin (SF) and a synthetic polymer, thermoplastic polyurethane (TPU), for surgical use.
The hybrid SF/TPU sheet was a non-woven fabric with nanofibers that was made using the electrospinning method. The mechanical properties of the SF/TPU sheet were characterized. To determine its biocompatibility, part of the wall of the canine descending aorta was replaced with a SF/TPU sheet as a patch. The patches were removed after 3 months and a histological examination was performed.
The flexibility, water permeability, and suture retention strength of the SF/TPU sheet were excellent and equivalent to those of existing sheets. The SF/TPU sheet had excellent handling properties and fit well into the vascular wall without needle hole bleeding. The histological examination revealed that the intimal tissue was restored well over the intraluminal surface of the explanted SF/TPU sheet, the absence of calcium deposition, and minimal inflammatory reaction, without signs of degradation.
The SF/TPU sheet had excellent mechanical properties and tissue biocompatibility. These favorable features and possible biodegradability of the SF portion warrant a long-term follow-up study.
KeywordsSilk fibroin Polyurethane Electrospinning Surgical sheet Cardiovascular surgery
We would like to express our sincere gratitude to Ms. Atsuko Ueda and to Ms. Madoka Omura for their careful management and surgery of the animal experiments in this study. This work is supported by a Scientific technique research promotion program of agriculture, forestry, fishery and food industry (26051A) from the Japanese Ministry of Agriculture, Forestry and Fisheries and a Grant-in-aid for Scientific Research (KAKENHI: 26462094 and 15H03020) from the Japanese Ministry of Education, Culture, Sports, Science and Technology Japan.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest in association with the present study.
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