CN112972060B - Device for preventing operation area from blocking after craniotomy in neurosurgery - Google Patents
Device for preventing operation area from blocking after craniotomy in neurosurgery Download PDFInfo
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- CN112972060B CN112972060B CN202110154492.XA CN202110154492A CN112972060B CN 112972060 B CN112972060 B CN 112972060B CN 202110154492 A CN202110154492 A CN 202110154492A CN 112972060 B CN112972060 B CN 112972060B
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- dura mater
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
- A61M31/002—Devices for releasing a drug at a continuous and controlled rate for a prolonged period of time
Abstract
The invention discloses a device for preventing operation area from blocking after craniotomy in neurosurgery, which comprises a subdural device positioned at the inner side of the dura mater and an extradural device positioned at the outer side of the dura mater; the subdural device consists of a concave lock catch layer, an artificial meninges layer, a super-hydrophilic coating and an antibiotic coating; the epidural device consists of a convex lock catch layer, an artificial meninges layer, a super-hydrophilic coating and an antibiotic coating; the invention fixes the invention with the dura mater by utilizing a concave, convex or concave-convex combined structure, thereby repairing potential fistulae on the dura mater and reducing the risk of postoperative cerebrospinal fluid fistulae; the norvancomycin-loaded drug-loaded slow-release layer is fixed on the outermost layer of the invention, and the characteristic of slow release of the membrane is utilized, so that the antibiotics in the operation area within 72 hours after operation are kept at effective concentration, the risk of infection in the operation area is reduced, and meanwhile, the super-hydrophilic coating exposed after the slow release of the drug-loaded layer is finished sequentially plays a role in preventing tissue adhesion.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a device for preventing tissue adhesion after craniotomy in neurosurgery.
Background
The scar adhesion of dura mater to surrounding tissue after craniotomy is a common complication of neurosurgery and has attracted increasing attention from neurosurgeons. Studies have shown that the adhesion of dura mater and cortical scar after craniocerebral surgery is one of the risk factors for the occurrence of epilepsy after surgery. Meanwhile, aiming at the common planned secondary operation (skull defect repair operation after craniocerebral trauma bone flap removal and decompression and recurrent focus excision operation of the operation area of tumor) of neurosurgery, the anatomical structure is not clear due to structural adhesion of the operation area, so that the craniotomy bleeding amount is increased, the operation time is prolonged and the operation difficulty is increased.
Currently, with the understanding of the mechanism of occurrence of scar adhesion of dura mater and the development of materials, more and more preventive measures are applied to clinic, such as treated autologous tissues (autologous fat sheets, small intestine mucosa, autologous bone plates and the like) and polymeric materials (postoperative anti-adhesion electrospun films). However, no evidence-based medical evidence is available to confirm the effectiveness of current anti-adhesion measures, and reports on surgical area infections and cerebrospinal fluid fistulas caused by implants are common.
In summary, the following problems exist in the prior art:
(1) The existing measures for preventing adhesion after neurosurgery operation do not have the effects of diminishing inflammation and sterilizing, and conversely, the risk of infection of an operation area is increased due to the existence of foreign matters.
(2) The existing measures for preventing adhesion after neurosurgery do not have the function of repairing potential dural fistulae, and cannot reduce the occurrence of postoperative cerebrospinal fluid fistulae.
(3) The existing measures for preventing adhesion after neurosurgery are usually only aimed at physical isolation between the dura mater and the brain parenchyma, but neglect the isolation between the dura mater and the hat-shaped aponeurosis after the bone flap removing and decompression operation, and cause serious adhesion during the skull defect repairing operation.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention provides a device for preventing the tissue adhesion of an operation area after the craniotomy of neurosurgery, which has the functions of reducing the scar adhesion of the operation area, defining the anatomical structure of the operation area and preventing cerebrospinal fluid fistula.
In order to solve the technical problems, the invention provides the following technical scheme:
a device for preventing tissue adhesion after craniotomy in neurosurgery, which is characterized by comprising a subdural device positioned inside the dura mater and an extradural device positioned outside the dura mater; the subdural device consists of a concave lock catch layer, an artificial meninges, a super-hydrophilic coating and an antibiotic coating; the epidural device consists of a convex lock catch layer, an artificial meninges, a super-hydrophilic coating and an antibiotic coating.
As a preferable technical scheme of the invention, one surface of the concave lock catch layer with the concave lock catch is adjacent to the inner layer of the dura mater and fixedly connected with the dura mater through a ligature, and the other surface of the concave lock catch layer is adjacent to the artificial dura mater and is fixed by glue;
as a preferable technical scheme of the invention, one surface of the convex lock catch layer with the convex lock catch is adjacent to the outer layer of the dura mater and fixedly connected with the dura mater through a ligature, and the other surface of the convex lock catch layer is adjacent to the artificial dura mater and is fixed by glue.
As a preferable technical scheme of the invention, the artificial meninges are made of expanded polytetrafluoroethylene high-molecular polymer materials, one surface of the artificial meninges is fixed with the lock catch layer by using glue, and the other surface of the artificial meninges is coated with an ultra-hydrophilic coating.
As a preferable technical scheme of the invention, the super-hydrophilic coating is made of BR type hydrophilic lubricating coating and is coated on the artificial meninges.
As a preferable technical scheme of the invention, the antibiotic coating is prepared from three layers of norvancomycin medicine-carrying films and is coated on the super-hydrophilic coating.
As a preferred embodiment of the present invention, the ligature is a non-absorbable suture.
Compared with the prior art, the invention has the following beneficial effects:
(1) The invention consists of a subdural device and an extradural device, and is suitable for the requirement of preventing adhesion after craniotomy in all neurosurgery.
(2) The invention fixes the invention with the dura mater by utilizing the concave, convex or concave-convex combined structure, thereby repairing the potential fistula on the dura mater and reducing the risk of post-operation cerebrospinal fluid fistula.
(3) According to the invention, the norvancomycin-loaded drug-loaded slow-release layer is fixed on the outermost layer of the invention, and the characteristic of slow release of the membrane is utilized, so that the antibiotics in the operation area within 72 hours after operation are kept at effective concentration, and the risk of infection in the operation area is reduced. Meanwhile, the super-hydrophilic coating exposed after the slow release of the medicine carrying layer is finished sequentially plays a role in preventing tissue adhesion.
(4) The invention utilizes the BR-type super-hydrophilic coating which is sequentially exposed to play a role in preventing the adhesion of the operation area. The medical grade water-soluble biopolymer is organically bound to the surface of the artificial meninges through a coupling agent. One end of the coupling agent is combined with the hydrophobic group on the surface of the artificial meninges, and the other end is combined with the water-soluble biopolymer. After the slow-release antibiotic coating is ablated, the super-hydrophilic coating is contacted with cerebrospinal fluid or tissue fluid, and the hydrophilic group of the water-soluble biopolymer is combined with water to quickly swell, so that a biological film similar to the surface of loach is formed, and the super-hydrophilic coating has excellent hydrophilic lubrication effect and effectively avoids adhesion in an operation area.
Drawings
FIG. 1 is a schematic view showing the overall structure of the working state (slow-release antibiotic state, bone flap removing state) of a device for preventing surgical tissue adhesion after craniotomy in neurosurgery;
FIG. 2 is a schematic view showing the overall structure of the operation state (slow release antibiotic, non-bone flap removed state) of the device for preventing the operation area from blocking after the craniotomy of the invention;
FIG. 3 is a schematic view showing the overall structure of the device for preventing the adhesion of the operation area after the craniotomy in neurosurgery (the slow release end state of the antibiotics);
wherein: 1. dura mater; 2. a male locking layer; 3. an antibiotic coating; 4. a superhydrophilic coating; 5. artificial meninges; 6. a concave locking layer; 7. and (5) ligating the wire.
Detailed Description
The preferred embodiments of the present invention will be described below with reference to the accompanying drawings, it being understood that the preferred embodiments described herein are for illustration and explanation of the present invention only, and are not intended to limit the present invention.
Referring to the first drawing, the invention is a schematic diagram of the overall working state structure (slow-release antibiotic state and bone flap removing state) of a device for preventing operation area tissue adhesion after craniotomy in neurosurgery. This state may be applied to the deboned, reduced pressure state, enabling the subdural and extradural devices. This state was within 72 hours post-surgery, during slow release of antibiotics.
Referring to the second drawing, the invention is a schematic diagram of the overall working state structure (slow-release antibiotics, non-bone flap removing state) of the device for preventing operation area tissue adhesion after craniotomy in neurosurgery. This state may be applied to a state of reduced pressure without removal of the bone flap, enabling the subdural device. This state was within 72 hours post-surgery, during slow release of antibiotics.
Referring to the third drawing, the invention is a general structural schematic diagram of a device for preventing operation area tissue adhesion after craniotomy in neurosurgery in a working state with slow release of antibiotics. This state may be applied to the deboned, reduced pressure state, enabling the subdural and extradural devices. After 72 hours from operation, the slow release of the antibiotics is finished, the super-hydrophilic coating is exposed, and the adhesion prevention effect is exerted.
The invention consists of a subdural device and an extradural device, and is suitable for the requirement of preventing adhesion after craniotomy in all neurosurgery.
The invention fixes the invention with the dura mater by utilizing the concave, convex or concave-convex combined structure, thereby repairing the potential fistula on the dura mater and reducing the risk of post-operation cerebrospinal fluid fistula.
According to the invention, the norvancomycin-loaded drug-loaded slow-release layer is fixed on the outermost layer of the invention, and the characteristic of slow release of the membrane is utilized, so that the antibiotics in the operation area within 72 hours after operation are kept at effective concentration, and the risk of infection in the operation area is reduced. Meanwhile, the super-hydrophilic coating exposed after the slow release of the medicine carrying layer is finished sequentially plays a role in preventing tissue adhesion.
The invention utilizes the BR-type super-hydrophilic coating which is sequentially exposed to play a role in preventing the adhesion of the operation area. The medical grade water-soluble biopolymer is organically bound to the surface of the artificial meninges through a coupling agent. One end of the coupling agent is combined with the hydrophobic group on the surface of the artificial meninges, and the other end is combined with the water-soluble biopolymer. After the slow-release antibiotic coating is ablated, the super-hydrophilic coating is contacted with cerebrospinal fluid or tissue fluid, and the hydrophilic group of the water-soluble biopolymer is combined with water to quickly swell, so that a biological film similar to the surface of loach is formed, and the super-hydrophilic coating has excellent hydrophilic lubrication effect and effectively avoids adhesion in an operation area.
The embodiments of the present invention are not limited thereto, and the above preferred embodiments may be modified, substituted or combined in various other forms, using conventional technical knowledge and means in the art, according to the above embodiments of the present invention, without departing from the basic technical ideas of the present invention, and all the obtained other embodiments fall within the scope of the claims of the present invention.
Claims (7)
1. A device for preventing operation area from blocking after craniotomy in neurosurgery, which is characterized by comprising a subdural device positioned at the inner side of the dura mater (1) and an extradural device positioned at the outer side of the dura mater (1); the subdural device consists of a concave locking layer (6), an artificial meninges layer (5), a super-hydrophilic coating (4) and an antibiotic coating (3); the epidural device consists of a convex lock catch layer (2), an artificial meninges layer (5), a super-hydrophilic coating layer (4) and an antibiotic coating layer (3).
2. The device for preventing surgical area tissue adhesion after neurosurgery craniotomy according to claim 1, wherein one side of the concave lock catch layer (6) with the concave lock catch is adjacent to the inner layer of the dura mater (1), is fixedly connected with the dura mater (1) through a ligature (7), and the other side is adjacent to the artificial dura mater (5) and is fixed by glue.
3. The device for preventing surgical area tissue adhesion after neurosurgery craniotomy according to claim 1, wherein one surface of the convex lock catch layer (2) with the convex lock catch is adjacent to the outer layer of the dura mater (1), is fixedly connected with the dura mater (1) through a ligature (7), and the other surface of the convex lock catch layer is adjacent to the artificial dura mater (5) and is fixed by glue.
4. The device for preventing surgical tissue adhesion after neurosurgery craniotomy according to claim 1, wherein the artificial meninges (5) are made of expanded polytetrafluoroethylene high-molecular polymer materials, one surface of the artificial meninges (5) is fixed with the lock catch layer by using glue, and the other surface of the artificial meninges is coated with the super-hydrophilic coating (4).
5. Device for preventing surgical tissue adhesions after neurosurgical craniotomy according to claim 1, characterized in that the super-hydrophilic coating (4) is made of a BR-type hydrophilic lubricating coating applied to the artificial meninges (5).
6. The device for preventing surgical tissue adhesion after neurosurgery craniotomy according to claim 1, wherein the antibiotic coating (3) is made of three layers of norvancomycin medicine-carrying films and coated on the super-hydrophilic coating (4).
7. A device for preventing surgical adhesions after neurosurgical craniotomy according to claim 2 or 3, characterized in that the ligature (7) is a non-absorbable suture.
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| CN202110154492.XA CN112972060B (en) | 2021-02-04 | 2021-02-04 | Device for preventing operation area from blocking after craniotomy in neurosurgery |
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| CN202110154492.XA CN112972060B (en) | 2021-02-04 | 2021-02-04 | Device for preventing operation area from blocking after craniotomy in neurosurgery |
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| CN112972060B true CN112972060B (en) | 2023-07-14 |
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| JP2003199817A (en) * | 2001-11-01 | 2003-07-15 | Kawasumi Lab Inc | Artificial dura mater |
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| CN101559242A (en) * | 2009-05-22 | 2009-10-21 | 广州迈普再生医学科技有限公司 | Nano artificial dura mater capable of being used as medicine sustained-release system and preparation method thereof |
| CN101692986A (en) * | 2009-03-10 | 2010-04-14 | 广州迈普再生医学科技有限公司 | Artificial dura mater with bioactivity and preparation method thereof |
| CN103418031A (en) * | 2012-05-17 | 2013-12-04 | 天津市康尔医疗器械有限公司 | Absorbable endocranium healing patch and preparation method thereof |
| CN106510896A (en) * | 2016-12-06 | 2017-03-22 | 王晓松 | Artificial cerebral dura mater |
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| EP2340785B1 (en) * | 2009-03-10 | 2016-05-18 | Medprin Regenerative Medical Technologies Co., Ltd. | Artificial dura mater and manufacturing method thereof |
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2021
- 2021-02-04 CN CN202110154492.XA patent/CN112972060B/en active Active
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| Publication number | Priority date | Publication date | Assignee | Title |
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| RU2201163C1 (en) * | 2001-08-16 | 2003-03-27 | Кемеровская городская клиническая больница № 3 им. М.А. Подгорбунского | Method for substituting dura mater defect |
| JP2003199817A (en) * | 2001-11-01 | 2003-07-15 | Kawasumi Lab Inc | Artificial dura mater |
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| CN101559242A (en) * | 2009-05-22 | 2009-10-21 | 广州迈普再生医学科技有限公司 | Nano artificial dura mater capable of being used as medicine sustained-release system and preparation method thereof |
| CN103418031A (en) * | 2012-05-17 | 2013-12-04 | 天津市康尔医疗器械有限公司 | Absorbable endocranium healing patch and preparation method thereof |
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| CN209092278U (en) * | 2018-07-27 | 2019-07-12 | 陕西佰傲再生医学有限公司 | A kind of compound antibacterial biological dural patch |
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| CN112972060A (en) | 2021-06-18 |
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