组织工程软骨缝合技术及缝合材料的研究与进展

背景：软骨组织的生理特征及其功能结构特点表面,其受损后自我康复较难,根据其受伤特点及受损区域可以进行相应缝合,但缝线材料的选择尤为重要,随着可吸收缝线材料的研制与运用,为软骨组织缝合技术的运用提供了更大保障。 目的：文章综述了软骨组织生理特征,医用缝合线材料研究进展及其运用情况,着重介绍了可吸收缝线的材料学特征及其临床运用效果,指导临床合理选择材料和对新材料进行开发或研制。 方法：应用计算机检索CNKI和PubMed数据库中1993-01/2011-01关于软骨损伤及医用缝线材料的文章,在标题和摘要中以“软骨;缝合线;材料”或“Cartilage; Seam; materials”为检索词进行检索。选择文章内容与缝线材料相关,同一领域文献则选择近期发表或发表在权威杂志文章。初检得到193篇文献,根据纳入标准选择30篇文章进行综述。 结果与结论：软骨的生理特征制约着自我修复的效果,一般认为较难恢复,所以大多采用切除手术,但切除手术后期效果不理想,应尽量保留软骨组织,同时研究发现软骨组织周边区域具有一定的自我修复功能,所以对于规则性裂伤进行缝合康复,后期效果较好。但又由于软骨组织特殊的功能结构及需体内手术,所以不可吸收缝合线很难避免二次伤害及手术效果不理想,可吸收缝合线的出现为软骨组织的缝合康复及其缝合技术的发展提供了更大可能和保障,随着缝合技术的进步及新型材料的研制成功,软骨缝合作为一种组织工程修复手段将会得到逐步运用和改良。

Suture technology and materials for tissue engineered cartilage

BACKGROUND:The physical characteristics and functional structure of cartilage tissue suppress its self-rehabilitation after injury. The injured area of cartilage tissue can be sutured according to injury characteristics. Therefore, the choice of suture materials is particularly important. The development and application of degradable suture materials provides a greater protection to the application of suture technology. OBJECTIVE:To review the physiological characteristics of cartilage tissue and progress and application of surgical suture materials, to introduce the material characteristics and clinical application of degradable suture materials, and to guide the rational selection of suture materials and development of new materials. METHODS: A computer-based search of CNKI and PubMed databases was performed for relevant articles published from 1993-01 to 2011-01 using the keywords of “cartilage; seam; materials” in Chinese and English. Articles published in recent years or in authorized journals were preferred. Finally, 30 of 193 articles were included in result analysis. RESULTS AND CONCLUSION:The physiological characteristics of the cartilage restrict the self-repair effect, so resection surgery is often used. However, the postoperative effects are not ideal. Generally considered, cartilage tissues should be retained as far as possible. Meanwhile, it is found that the surrounding area of cartilage tissues has some self-repair ability. Therefore, to suture regular laceration can obtain a good effect. Degradable suture thread superior to non-degradable one cannot lead to secondary injury and provide a great potential and security for suture rehabilitation of cartilage tissue and suture technology development. With the advances in suture technology and development of new materials, cartilage suture repair as tissue engineering method can be used and improved gradually.