WO2008065329A2 - Protein sheet material - Google Patents
Protein sheet material Download PDFInfo
- Publication number
- WO2008065329A2 WO2008065329A2 PCT/GB2007/004033 GB2007004033W WO2008065329A2 WO 2008065329 A2 WO2008065329 A2 WO 2008065329A2 GB 2007004033 W GB2007004033 W GB 2007004033W WO 2008065329 A2 WO2008065329 A2 WO 2008065329A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- sheet
- protein
- sheet material
- gas bubbles
- layer
- Prior art date
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- 244000005700 microbiome Species 0.000 description 1
- 239000000178 monomer Substances 0.000 description 1
- 229960003128 mupirocin Drugs 0.000 description 1
- 229930187697 mupirocin Natural products 0.000 description 1
- DDHVILIIHBIMQU-YJGQQKNPSA-L mupirocin calcium hydrate Chemical compound O.O.[Ca+2].C[C@H](O)[C@H](C)[C@@H]1O[C@H]1C[C@@H]1[C@@H](O)[C@@H](O)[C@H](C\C(C)=C\C(=O)OCCCCCCCCC([O-])=O)OC1.C[C@H](O)[C@H](C)[C@@H]1O[C@H]1C[C@@H]1[C@@H](O)[C@@H](O)[C@H](C\C(C)=C\C(=O)OCCCCCCCCC([O-])=O)OC1 DDHVILIIHBIMQU-YJGQQKNPSA-L 0.000 description 1
- 229960004927 neomycin Drugs 0.000 description 1
- 229910052757 nitrogen Inorganic materials 0.000 description 1
- 229940021182 non-steroidal anti-inflammatory drug Drugs 0.000 description 1
- 239000004745 nonwoven fabric Substances 0.000 description 1
- 229960005489 paracetamol Drugs 0.000 description 1
- 239000001814 pectin Substances 0.000 description 1
- 235000010987 pectin Nutrition 0.000 description 1
- 229920001277 pectin Polymers 0.000 description 1
- 150000002960 penicillins Chemical class 0.000 description 1
- 210000003516 pericardium Anatomy 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 230000003169 placental effect Effects 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 229920000747 poly(lactic acid) Polymers 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 239000004633 polyglycolic acid Substances 0.000 description 1
- 239000004626 polylactic acid Substances 0.000 description 1
- 239000002861 polymer material Substances 0.000 description 1
- WQVJHHACXVLGBL-GOVYWFKWSA-N polymyxin B1 Polymers N1C(=O)[C@H](CCN)NC(=O)[C@@H](NC(=O)[C@H](CCN)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)CCCC[C@H](C)CC)CCNC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCN)NC(=O)[C@H](CCN)NC(=O)[C@H](CC(C)C)NC(=O)[C@H]1CC1=CC=CC=C1 WQVJHHACXVLGBL-GOVYWFKWSA-N 0.000 description 1
- 229920006264 polyurethane film Polymers 0.000 description 1
- 229960001621 povidone-iodine Drugs 0.000 description 1
- 102000004196 processed proteins & peptides Human genes 0.000 description 1
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- 238000012545 processing Methods 0.000 description 1
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- 150000003242 quaternary ammonium salts Chemical class 0.000 description 1
- 150000003839 salts Chemical class 0.000 description 1
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- 229920005573 silicon-containing polymer Polymers 0.000 description 1
- 150000003378 silver Chemical class 0.000 description 1
- 229960003600 silver sulfadiazine Drugs 0.000 description 1
- UEJSSZHHYBHCEL-UHFFFAOYSA-N silver(1+) sulfadiazinate Chemical compound [Ag+].C1=CC(N)=CC=C1S(=O)(=O)[N-]C1=NC=CC=N1 UEJSSZHHYBHCEL-UHFFFAOYSA-N 0.000 description 1
- 239000002002 slurry Substances 0.000 description 1
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- 239000000600 sorbitol Substances 0.000 description 1
- 150000003431 steroids Chemical class 0.000 description 1
- 238000003756 stirring Methods 0.000 description 1
- 229960004291 sucralfate Drugs 0.000 description 1
- MNQYNQBOVCBZIQ-JQOFMKNESA-A sucralfate Chemical compound O[Al](O)OS(=O)(=O)O[C@@H]1[C@@H](OS(=O)(=O)O[Al](O)O)[C@H](OS(=O)(=O)O[Al](O)O)[C@@H](COS(=O)(=O)O[Al](O)O)O[C@H]1O[C@@]1(COS(=O)(=O)O[Al](O)O)[C@@H](OS(=O)(=O)O[Al](O)O)[C@H](OS(=O)(=O)O[Al](O)O)[C@@H](OS(=O)(=O)O[Al](O)O)O1 MNQYNQBOVCBZIQ-JQOFMKNESA-A 0.000 description 1
- 239000003356 suture material Substances 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 210000002435 tendon Anatomy 0.000 description 1
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- 229960002180 tetracycline Drugs 0.000 description 1
- 229930101283 tetracycline Natural products 0.000 description 1
- 235000019364 tetracycline Nutrition 0.000 description 1
- 150000003522 tetracyclines Chemical class 0.000 description 1
- 229940124597 therapeutic agent Drugs 0.000 description 1
- 239000012815 thermoplastic material Substances 0.000 description 1
- 229960003500 triclosan Drugs 0.000 description 1
- VBEQCZHXXJYVRD-GACYYNSASA-N uroanthelone Chemical compound C([C@@H](C(=O)N[C@H](C(=O)N[C@@H](CS)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CS)C(=O)N[C@H](C(=O)N[C@@H]([C@@H](C)CC)C(=O)NCC(=O)N[C@@H](CC=1C=CC(O)=CC=1)C(=O)N[C@@H](CO)C(=O)NCC(=O)N[C@@H](CC(O)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CS)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CC(O)=O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCCNC(N)=N)C(O)=O)C(C)C)[C@@H](C)O)NC(=O)[C@H](CO)NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CO)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@@H](NC(=O)[C@H](CC=1NC=NC=1)NC(=O)[C@H](CCSC)NC(=O)[C@H](CS)NC(=O)[C@@H](NC(=O)CNC(=O)CNC(=O)[C@H](CC(N)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CS)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)CNC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@H]1N(CCC1)C(=O)[C@H](CS)NC(=O)CNC(=O)[C@H]1N(CCC1)C(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CO)NC(=O)[C@@H](N)CC(N)=O)C(C)C)[C@@H](C)CC)C1=CC=C(O)C=C1 VBEQCZHXXJYVRD-GACYYNSASA-N 0.000 description 1
- 229920002554 vinyl polymer Polymers 0.000 description 1
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Classifications
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B32—LAYERED PRODUCTS
- B32B—LAYERED PRODUCTS, i.e. PRODUCTS BUILT-UP OF STRATA OF FLAT OR NON-FLAT, e.g. CELLULAR OR HONEYCOMB, FORM
- B32B9/00—Layered products comprising a layer of a particular substance not covered by groups B32B11/00 - B32B29/00
- B32B9/02—Layered products comprising a layer of a particular substance not covered by groups B32B11/00 - B32B29/00 comprising animal or vegetable substances, e.g. cork, bamboo, starch
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
- A61L15/32—Proteins, polypeptides; Degradation products or derivatives thereof, e.g. albumin, collagen, fibrin, gelatin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/425—Porous materials, e.g. foams or sponges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/64—Use of materials characterised by their function or physical properties specially adapted to be resorbable inside the body
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B32—LAYERED PRODUCTS
- B32B—LAYERED PRODUCTS, i.e. PRODUCTS BUILT-UP OF STRATA OF FLAT OR NON-FLAT, e.g. CELLULAR OR HONEYCOMB, FORM
- B32B9/00—Layered products comprising a layer of a particular substance not covered by groups B32B11/00 - B32B29/00
- B32B9/04—Layered products comprising a layer of a particular substance not covered by groups B32B11/00 - B32B29/00 comprising such particular substance as the main or only constituent of a layer, which is next to another layer of the same or of a different material
- B32B9/047—Layered products comprising a layer of a particular substance not covered by groups B32B11/00 - B32B29/00 comprising such particular substance as the main or only constituent of a layer, which is next to another layer of the same or of a different material made of fibres or filaments
-
- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08J—WORKING-UP; GENERAL PROCESSES OF COMPOUNDING; AFTER-TREATMENT NOT COVERED BY SUBCLASSES C08B, C08C, C08F, C08G or C08H
- C08J9/00—Working-up of macromolecular substances to porous or cellular articles or materials; After-treatment thereof
- C08J9/34—Chemical features in the manufacture of articles consisting of a foamed macromolecular core and a macromolecular surface layer having a higher density than the core
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B32—LAYERED PRODUCTS
- B32B—LAYERED PRODUCTS, i.e. PRODUCTS BUILT-UP OF STRATA OF FLAT OR NON-FLAT, e.g. CELLULAR OR HONEYCOMB, FORM
- B32B2535/00—Medical equipment, e.g. bandage, prostheses, catheter
Definitions
- the present invention relates to improved protein sheet materials for use in wound dressings, and for other medical applications.
- the invention further relates to wound dressings comprising such materials, and to methods of manufacture of such materials.
- Protein-based sheet materials for use as wound dressings and in tissue repair are known. Many such sheet materials are based on collagen that has been processed in various ways to form a biodegradable wound dressing material.
- Layered or laminated structures comprising collagen are known for the production of "synthetic skin".
- synthetic skin For example, US-A-3800792 describes a laminated collagen film dressing made from a thicker layer of collagen compressed foam film, to which has been laminated a thin continuous layer of an inert polymer material such as polyurethane.
- WO95/18638 describes resorbable collagen membranes for use in guided tissue regeneration wherein one face of the membrane is fibrous thereby allowing cell growth thereon and the opposite face of the membrane is smooth, thereby inhibiting cell growth thereon.
- the membranes are made by processing mammalian pericardium, placental or basal membranes to remove non-collagenous components therefrom.
- the membranes are commercially available from Geistlich Sonne AG under the Registered Trade Mark BIO-GIDE.
- WO03/077964 describes a process for the preparation of a hydrogel sheet that comprises polymerising a polymerisable mixture comprising an acrylate monomer, wherein the polymerisable mixture prior to polymerisation comprises a first portion including a relatively high concentration of introduced gas bubbles and a second portion including a relatively low concentration of gas bubbles, whereby the resulting polymerised material comprises a region with a relatively high concentration of gas bubbles.
- the present invention provides a sheet material consisting essentially of a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet.
- the sheet materials according to the invention therefore consist essentially of a single, integral plasticized protein matrix sheet comprising a first region (layer) on one side thereof that is porous due to the presence of gas bubbles in the matrix, and a second region (layer) on the side thereof opposite the first region that is substantially continuous.
- the porous layer is a substantially closed-cell foam layer, in contrast to previous collagen foams formed, for example, by lyophilisation, that are predominantly open-cell foams.
- the porous layer allows cell attachment and cell infiltration, while the continuous layer acts as a barrier to infection, dehydration and cellular ingrowth. These properties are important if the material is to function as a dermal substitute.
- the two regions are expected to exhibit different rates of degradation in vivo, with the porous region being degraded quickly and the continuous region being degraded at a slower rate.
- the combination is both highly elastic and strong and could be used for a variety of tissue repair purposes. For example wound healing, bone repair, tendon repair, hernia repair, or bladder repair.
- the porous nature of the bottom layer and the film properties of the top layer may render the sheet materials particularly suitable as hemostats.
- a further advantage of the thin integral bilayer structure of the invention is that the porous layer makes the sheet opaque. This solves a customer need for an opaque film for re-epithelization. Clinicians prefer wound dressing films to be opaque, rather than transparent, as the material then has an appearance similar to the dermis.
- the thickness of the layer of entrapped gas bubbles is from about 10% to about 90% of the thickness of the sheet, for example from about 25% to about 75% of the thickness of the sheet and typically about 50% of the thickness of the sheet.
- the entrapped gas bubbles occupy from about 10% to about 95% of the volume of the layer of entrapped gas bubbles, for example from about 30% to about 75% of the layer. It follows that the entrapped gas bubbles occupy from about 1% to about 85% of the volume of the sheet, suitably from about 5% to about 60% of the volume of the sheet.
- the density of the sheet is from about 99% to about 15%, suitably from about 80% to about 50% of the theoretical density of a solid sheet of the protein matrix without entrapped gas bubbles.
- the mean diameter of the entrapped gas bubbles is from about 25 micrometers to about 1 mm, for example from about 50 micrometers to about 500 micrometers.
- the resulting small pore sizes allow for a better surface area for cell attachment and allow for better mechanical strength and maintenance of structural integrity.
- Providing the pore size is greater than that of the diameter of the migrating cell (typically about lO ⁇ m) the smaller the pore size, the better for tissue ingrowth.
- the optimal pore size for the regeneration of skin is thought to be about 20 to about 150 ⁇ m, while the optimum pore size for regeneration of bone is about 100 to about 400 ⁇ m, and for osteoid ingrown is about 40 to about lOO ⁇ m.
- the gas bubbles suitably contain air, or an inert gas such as nitrogen or argon.
- the thickness of the sheet can be controlled over a wide range.
- the total thickness of the sheet is from about 0.1mm to about 10mm, preferably from about 0.5mm to about 5mm.
- thinner sheets may be preferable.
- thicker sheets are preferred.
- the protein matrix comprises a major fraction of one or more proteins. That is to say, more than about 50%, preferably at least about 75%, and more preferably at least about 90% of the solid components of the matrix by weight consists of one or more proteins. It is thought that a wide range of purified or freeze-dried or powdered medically acceptable proteins could be used. Suitable medically acceptable proteins for making the matrix include naturally occurring structural proteins such as collagen, elastin, fibronectin, laminin, fibrin, tenascin, vitronectin, keratins (methods to solubilize keratins are known), as well as other proteins of the human connective tissue matrix. Other suitable proteins include serum proteins such as albumin and globulins.
- Whey proteins can also be used, and may also have beneficial effects on healing. Proteins that are water-soluble before cross-linking, but that can be made substantially insoluble by cross-linking as described below, are preferred. In addition, fragments or peptides derived form the above- identified naturally occurring proteins could be used.
- a suitable protein for forming the matrix is collagen.
- the collagen may be any collagen, including Type I or Type II or Type III collagen, natural fibrous collagen, atelocollagen, partially hydrolysed collagens such as gelatin, and combinations thereof.
- Type IV collagen could also be incorporated as this is component of basal membrane and may aid would healing.
- Recombinant human collagen for example as described in US-A- 5962648 and WO-A-2004078120 may be used.
- Natural collagen for example of bovine origin, is suitable.
- the protein matrix comprises a dehydrothermally crosslinked collagen.
- the protein is not succinylated.
- the matrix may comprise a minor amount of one or more medically acceptable polymers other than proteins.
- the term "minor amount” implies that the other medically acceptable polymers are present in an amount of less than about 40% of the solid components of the matrix, preferably less than about 25%, for example about 1% to about 25% by weight.
- the medically acceptable polymers may for example be selected from polyurethanes, biopolymers, carboxymethyl celluloses, hydroxyethyl celluloses, hydroxy propyl methyl celluloses, modified acrylamides and mixtures thereof. Suitable biopolymers include alginates, pectins, galactomannans, chitosan, gelatin, hyaluronates and mixtures thereof. Some of these biopolymer materials also promote wound healing.
- Suitable plasticisers include low molecular weight hydrophilic materials.
- the plasticizers should preferably be liquids at room temperature (about 25°C).
- the plasticizers may comprise lipids or fatty alcohols.
- Preferred plasticisers include polyhydric alcohols such as glycols and sugar alcohols, since these plasticizers also function as humectants.
- Suitable glycols include glycerol, propylene glycol and low molecular weight polyethylene glycols generally having molecular weights below 600.
- Suitable sugar alcohols include sorbitol. These may be used alone or in mixtures.
- the amount of plasticizer in the matrix composition is from about 2wt.% to about 50wt.%, preferably from about 5wt.% to about 25wt.% based on the weight of the matrix.
- the amount of plasticizer is chosen to provide a sheet that is flexible, conformable, continuous and elastic while still forming a solid after crosslinking and drying.
- the weight ratio of plasticiser to total protein will depend on whether protein is inherently soluble (e.g serum proteins) or structural (gelatin or collagen).
- the weight ratio of plasticizer to total protein is suitably from about 2:1 to about 1 :10, preferably from about 1:1 to about 1:5. For example, a range of about 1:1 to about 3:2 ( plasticizer to protein) was best for gelatin. A ration of about 1 :2 to about 1 :5 was best for albumin.
- the sheet materials according to the present invention have an elongation at break greater than about 100% when measured by the method of Procedure 2 below.
- the sheet materials according to the present invention are suitably substantially insoluble in water at physiological pH of about 6 to about 8 and physiological temperatures of about 40°C.
- the low solubility of the sheet materials may be achieved by cross-linking the protein after formation of the sheet.
- the cross-linking may be chemical cross-linking, for example by treatment with hexamethylene diisocyanate (HMDI) or glutaraldehyde.
- HMDI hexamethylene diisocyanate
- glutaraldehyde glutaraldehyde
- chemical cross-linking may give rise to antigenicity of the materials, and therefore the cross-linking may preferably be so-called dehydrothermal cross-linking achieved by drying the sheet materials at elevated temperatures, e.g. temperatures above about 50°C, preferably temperatures above 80°C.
- the sheet materials according to the present invention are suitably fully biodegradable and resorbable in vivo. This can usually be achieved by appropriate selection of the protein, since wound fluids contain a range of protease enzymes.
- collagen, gelatine and albumin are fully biodegradable and resorbable in vivo.
- the sheet materials according to the present invention are suitably substantially dry. In certain embodiments, they may comprise up to about 20% by weight, preferably from about 2% to about 10% by weight of water.
- the sheet materials according to the present invention may also comprise up to about 10% by weight, for example from about 0.01 to about 5% by weight, typically from about 0.1 to about 2% by weight of one or more wound healing therapeutic agents, such as non-steroidal anti-inflammatory drugs (e.g. acetaminophen), steroids, local anaesthetics, antimicrobial agents, cytokines or growth factors.
- the antimicrobial agent may, for example, comprise an antiseptic, an antibiotic, or mixtures thereof.
- Preferred antibiotics include tetracycline, penicillins, terramycins, erythromycin, bacitracin, neomycin, polymycin B, mupirocin, clindamycin and mixtures thereof.
- Preferred antiseptics include silver, including colloidal silver, silver salts (including salts of one or more anionic polymers such as ORC or alginate), silver sulfadiazine, chlorhexidine, povidone iodine, triclosan, sucralfate, quaternary ammonium salts and mixtures thereof.
- the amount of silver (as silver ions and metallic silver) in the materials according to the present invention is from about 0.01wt% to about 2wt.%, more preferably from about 0.05wt% to about 0.5wt.%, and most preferably about 0.1wt.% to about 0.3wt.%. Lesser amounts of silver could give insufficient antimicrobial effect.
- the growth factors may comprise fibroblast growth factor (FGF), platelet derived growth factor (PDGF), epidermal growth factor (EGF), transforming growth factor alpha (TGF-alpha), transforming growth factor beta (TGF-beta), or combinations thereof.
- FGF fibroblast growth factor
- PDGF platelet derived growth factor
- EGF epidermal growth factor
- TGF-alpha transforming growth factor alpha
- TGF-beta transforming growth factor beta
- the sheet material may alternatively or additionally comprise fibronectin, which is thought to promote regeneration of the extracellular matrix in the wound.
- the present invention provides a sheet material comprising a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet and having a layer of a reinforcing material embedded in the matrix or bonded to a surface of the matrix.
- the matrix is reinforced by a layer of a synthetic bioabsorbable material.
- the layer may be in the form of a continuous or perforated sheet or web.
- the layer is a mesh or a woven, nonwoven or knitted fabric.
- Preferred bioabsorbable polymers for forming the reinforcing mesh or fabric include suture materials such as copolymers of lactic acid and glycolic acid, or oxidised regenerated cellulose.
- a particularly preferred synthetic bioabsorbable polymer is the polylactic/polyglycolic acid copolymer sold under the Registered Trade Mark VICRYL. Also particularly preferred is the oxidised regenerated cellulose mesh sold under the Registered Trade Mark SURGICEL.
- the structure and composition of the protein matrix are as described above in relation to the first aspect of the invention.
- the sheet material according to the present invention is sterile and packaged in a microorganism-impermeable container.
- the present invention provides a wound dressing comprising a sheet material according to the present invention.
- the wound dressing may consist essentially of the sheet material according to the invention, or it may further comprise additional layers.
- the sheet material according to the invention would normally be the wound contacting layer of the dressing in use, and the surface of the sheet containing the entrapped bubbles would normally be the wound facing surface.
- the area of the layer of sheet material according to the invention in the wound dressing is from about lcm 2 to about 400 cm 2 , more preferably from about 4cm to about 100cm .
- the wound dressing further comprises a backing sheet extending over the sheet material opposite to the wound facing side of the sheet material.
- the backing sheet is larger than the sheet material according to the invention such that a marginal region of width lmm to 50mm, preferably 5mm to 20mm extends around the sheet material to form a so-called island dressing.
- the backing sheet is preferably coated with a pressure sensitive medical grade adhesive in at least its marginal region.
- the backing sheet is substantially liquid-impermeable.
- the backing sheet is preferably semipermeable. That is to say, the backing sheet is preferably permeable to water vapour, but not permeable to liquid water or wound exudate.
- the backing sheet is also microorganism-impermeable.
- Suitable continuous conformable backing sheets will preferably have a moisture vapor transmission rate (MVTR) of the backing sheet alone of 300 to 5000 g/m 2 /24hrs, preferably 500 to 2000 g/ni 2 /24hrs at 37.5 °C at 100% to 10% relative humidity difference.
- the backing sheet thickness is preferably in the range of 10 to 1000 micrometers, more preferably 100 to 500 micrometers. It has been found that such moisture vapor transmission rates allow the wound under the dressing to heal under moist conditions without causing the skin surrounding the wound to macerate.
- Suitable polymers for forming the backing sheet include polyurethanes and poly alkoxyalkyl acrylates and methacrylates such as those disclosed in GB-A-1280631.
- the backing sheet comprises a continuous layer of a high density blocked polyurethane foam that is predominantly closed-cell.
- a suitable backing sheet material is the polyurethane film available under the Registered Trade Mark ESTANE 5714F.
- the adhesive (where present) layer should be moisture vapor transmitting and/or patterned to allow passage of water vapor therethrough.
- the adhesive layer is preferably a continuous moisture vapor transmitting, pressure-sensitive adhesive layer of the type conventionally used for island-type wound dressings, for example, a pressure sensitive adhesive based on acrylate ester copolymers, polyvinyl ethyl ether and polyurethane as described for example in GB-A-1280631.
- the basis weight of the adhesive layer is preferably 20 to 250 g/m 2 , and more preferably 50 to 150 g/m 2 . Polyurethane-based pressure sensitive adhesives are preferred. Further layers of a multilayer absorbent article may be built up between the protein sheet material and the protective backing sheet.
- these layers may comprise an absorbent layer between the protein sheet and the backing sheet, especially if the dressing is for use on exuding wounds.
- the optional absorbent layer may be any of the layers conventionally used for absorbing wound fluids, serum or blood in the wound healing art, including hydrophilic foams, gauzes, nonwoven fabrics, superabsorbents, hydrogels and mixtures thereof.
- the basis weight of the absorbent layer may be in the range of 50-500g/m 2 , such as 100-400g/m 2 .
- the uncompressed thickness of the absorbent layer may be in the range of from 0.5mm to 10mm, such as lmm to 4mm.
- the free (uncompressed) liquid absorbency measured for physiological saline may be in the range of 5 to 30 g/g at 25°.
- the absorbent layer or layers are substantially coextensive with the active layer.
- the wound facing surface of the dressing may be protected by a removable cover sheet.
- the cover sheet is normally formed from flexible thermoplastic material. Suitable materials include polyesters and polyolefms.
- the adhesive- facing surface of the cover sheet is a release surface. That is to say, a surface that is only weakly adherent to the protein sheet material and the adhesive on the backing sheet to assist peeling of the adhesive layer from the cover sheet.
- the cover sheet may be formed from a non-adherent plastic such as a fluoropolymer, or it may be provided with a release coating such as a silicone or fluoropolymer release coating.
- the wound dressing according to the present invention is sterile and packaged in a microorganism-impermeable container.
- the present invention provides a method of manufacture of a protein sheet material comprising the steps of: dispersing a protein in a solvent to form a liquid dispersion; dispersing gas bubbles in the liquid dispersion; spreading the liquid dispersion containing the dispersed gas bubbles to form a sheet thereof; allowing the gas bubbles to rise towards the top of said sheet to form distinct foamed and unfoamed layers in the sheet; crosslinking the protein in the foamed dispersion sheet; and drying the foamed dispersion sheet.
- the dimensions of the bubbles and the relative dimensions of the foamed and unfoamed layers are substantially as described above in relation to the sheet materials of the invention.
- the solvent is an aqueous solvent, and preferably it is water.
- the solvent may be acidified, for example to a pH less than about 5, for example to achieve swelling and gelation of dispersed collagen.
- Other components of the sheet material as hereinbefore described may be dispersed in the solvent before or after dispersion of the protein.
- the protein may be any of the proteins hereinbefore described in relation to the sheet materials of the invention.
- the protein is a soluble in the solvent, in which case the dispersion is a solution.
- the concentration of the protein in the solvent is suitably adjusted to produce a dispersion of moderate viscosity, whereby bubbles formed in the dispersion separate into a distinct layer in a relatively short time, but the viscosity is not so low that the bubbles escape from the solution completely before the drying and cross linking are complete.
- Typical protein concentrations in the dispersion are from about 1% by weight to about 50% by weight, for example from about 10% by weight to about 30% by weight, based on the weight of the dispersion. If a concentrated protein solution is used and the viscosity is to great to mix to get solubilization or to get a froth, then mild warming of the solution may be beneficial to reduce the viscosity.
- the step of foaming the liquid dispersion may be carried out by shaking, whisking or by gas injection.
- the dispersion is substantially free of surfactants or other added foaming agents, whereby the formation of larger bubbles in the dispersion is avoided.
- the step of spreading the foamed dispersion may be performed by any conventional method, such as by pouring the dispersion into a tray mold or spreading the dispersion onto a suitable release surface.
- the mold or release surface may be profiled, for example with an array of projections, in order to produce a sheet having a profiled bottom (i.e. substantially non-porous) surface. Suitable profiled mold surfaces are described, for example, in WO2004/052414.
- the foamed dispersion may be cast or spread onto a layer of the reinforcing mesh as hereinbefore described, and allowed to penetrate into the mesh.
- the dispersion may be left for a suitable time after spreading to allow the bubbles in the dispersion to separate into a distinct layer in the top of the dispersion layer.
- the step of crosslinking may be carried out before, after, or simultaneously with the step of drying.
- Chemical crosslinking may be achieved by the use of conventional crosslinking agents such as glutaraldehyde or HMDL
- the steps of crosslinking and drying are performed simultaneously in a dehydrothermal crosslinking step.
- the dehydrothermal crosslinking step is suitably carried out at a temperature of at least about 50°C, typically at a temperature of about 60°C to about 150°C, for example at a temperature of about 80°C to about 100°C.
- the time of heating will be dependent on the thickness of the material being prepared.
- the step of drying is carried out at substantially atmospheric pressure, i.e. not under substantially reduced pressure as in lyophilisation.
- the basic bilayer sheet structure can be made with a protein, plasticizer and water.
- the thickness of the sheet and the relative thicknesses of the porous and continuous layers can readily be controlled. Importantly, no chemical crosslinking reagents, solvents, surfactants, or freeze-drying steps are required.
- the method according to the present invention is adapted for the preparation of a sheet material according to the present invention.
- Figure 1 shows a cross-sectional view through a portion of protein sheet material according to the present invention
- Figure 2 shows a cross-sectional view through a portion of a reinforced protein sheet material according to the present invention
- Figure 3 shows a perspective view of a wound dressing according to the present invention.
- the sheet 1 comprises a plasticized collagen matrix comprising a continuous layer 2 on one side thereof, and a layer 3 of entrapped gas bubbles 4 on the other side thereof.
- the reinforced sheet 5 comprises a plasticized collagen matrix comprising a continuous layer 7 on one side thereof, and a layer 6 of entrapped gas bubbles on the other side thereof.
- a reinforcing layer 8 of SURGICEL (Registered Trade Mark) oxidized regenerated cellulose fabric is embedded in the continuous gel layer 7.
- the wound dressing 10 is an island-type, self-adhesive wound dressing comprising a backing layer 12 of microporous liquid-impermeable polyurethane foam, such as ESTANE 5714F (Registered Trade Mark).
- the backing layer 12 is permeable to water vapor, but impermeable to wound exudate and microorganisms.
- the backing layer is coated with a substantially continuous layer of pressure-sensitive polyurethane adhesive.
- An island 11 of the sheet material according to the present invention is adhered to a central region of the adhesive-coated backing sheet 12 such that an adhesive-coated margin 13 of the backing sheet extends around the island for attachment of the dressing to the skin around a wound.
- the island is adhered to the backing sheet by the continuous face thereof, whereby the porous face of the sheet according to the invention faces the wound in use.
- Protective release-coated cover sheets 14,15 are provided as shown in Fig. 3. These cover sheets are removed immediately before use of the dressing.
- albumin sheet having a bilayer structure, i.e. a continuous gel layer on one side and a foamed layer comprising entrapped air bubbles on the other side.
- solution B 20ml of solution B (see example 1 above) was added to 2.1 g of an ORC/collagen aqueous slurry (1.3% solids; pH3; ORCxollagen weight ratio of 45:55) prepared as described in Example 1 of EP-A-1153622.
- the solution was mixed to form a froth, poured and dried at 80 0 C for lhr.
- a stock solution was prepared from the following components: 34% (w/w) albumin (Sigma A4503), 12% (w/w) glycerol (Sigma G6279) and 56% (w/w) water.
- Composition 10% gelatin (Fluka 48723); 15% glycerol (Sigma G6279); 75% water.
- the glycerol was added to 75g of water and mixed. 10 g of gelatin was slowly added to the mixture with constant stirring.
- the mixture was heated to about 40 0 C during mixing to allow the gelatin to go into solution more rapidly. 20ml was then removed and placed into a clean 50ml Falcon tube. The material was shaken for 2 minutes to produce a froth that was poured in a
- a stock solution was prepared containing 10% (w/w) gelatin, 15 % glycerol and 75% glycerol.
- Sheet materials according to the invention were cut into small strips (3mm wide and viewed down a Nikon Eclipse TE2000 microscope (x2 magnification). Lengths were calibrated (in mm) using the microscope calibration tool in the Lucia G software. Linear distances were determined for a) Total thickness of bilayer; b) thickness of film layer; c) thickness of foam (porous) layer and d) diameter of pores.
- Table 1 Sheet 10 (10% glycerol, 10% gelatin)
- the average pore size of the three samples was 106 ⁇ 50 ⁇ m (sample 10), 55 ⁇ 21 ⁇ m (sample 11) and 104 ⁇ 68 ⁇ m (sample 12).
- the small pore sizes allow for a better surface area for cell attachment and allow for better mechanical strength and maintenance of structural integrity.
- Providing the pore size is greater than that of the diameter of the migrating cell (typically lO ⁇ m) the smaller the pore size the better for tissue in growth.
- the optimal pore size for the regeneration of skin is thought to be 20-15 O ⁇ m, while the optimum pore size for regeneration of bone is 100-400um, and for osteoid ingrown is 40-100 ⁇ m. From the data shown here the sheet materials according to the present invention should be well suited for many types of tissue repair.
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Abstract
A sheet material consisting essentially of a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet. Also provided is a sheet material of similar structure comprising a reinforcing layer. Also provided is a method of manufacture of a protein sheet material comprising the steps of: dispersing a protein in a solvent to form a liquid dispersion; dispersing gas bubbles in the liquid dispersion; spreading the liquid dispersion containing the dispersed gas bubbles to form a sheet thereof; allowing the gas bubbles to rise towards the top of said sheet to form distinct foamed and unfoamed layers in the sheet; crosslinking the protein in the foamed dispersion sheet; and drying the foamed dispersion sheet.
Description
PROTEIN SHEET MATERIAL
The present invention relates to improved protein sheet materials for use in wound dressings, and for other medical applications. The invention further relates to wound dressings comprising such materials, and to methods of manufacture of such materials.
Protein-based sheet materials for use as wound dressings and in tissue repair are known. Many such sheet materials are based on collagen that has been processed in various ways to form a biodegradable wound dressing material.
Layered or laminated structures comprising collagen are known for the production of "synthetic skin". For example, US-A-3800792 describes a laminated collagen film dressing made from a thicker layer of collagen compressed foam film, to which has been laminated a thin continuous layer of an inert polymer material such as polyurethane.
WO95/18638 describes resorbable collagen membranes for use in guided tissue regeneration wherein one face of the membrane is fibrous thereby allowing cell growth thereon and the opposite face of the membrane is smooth, thereby inhibiting cell growth thereon. The membranes are made by processing mammalian pericardium, placental or basal membranes to remove non-collagenous components therefrom. The membranes are commercially available from Geistlich Sonne AG under the Registered Trade Mark BIO-GIDE.
R. Sripriya et al. in J. Biomed. Mater. Res. Part B: Applied Biomaterials 70B: 389-396 (2004) describe dressings formed from a layer of a succinylated collagen sponge laminated to a layer of succinylated collagen film. The collagen sponge is produced by agitating a succinylated collagen solution with a surfactant, followed by drying the resulting frothy collagen mass at a temperature not exceeding 35°C.
WO03/077964 describes a process for the preparation of a hydrogel sheet that comprises polymerising a polymerisable mixture comprising an acrylate monomer, wherein the polymerisable mixture prior to polymerisation comprises a first portion including a relatively high concentration of introduced gas bubbles and a second portion including a
relatively low concentration of gas bubbles, whereby the resulting polymerised material comprises a region with a relatively high concentration of gas bubbles.
In a first aspect, the present invention provides a sheet material consisting essentially of a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet.
The sheet materials according to the invention therefore consist essentially of a single, integral plasticized protein matrix sheet comprising a first region (layer) on one side thereof that is porous due to the presence of gas bubbles in the matrix, and a second region (layer) on the side thereof opposite the first region that is substantially continuous. The porous layer is a substantially closed-cell foam layer, in contrast to previous collagen foams formed, for example, by lyophilisation, that are predominantly open-cell foams.
The porous layer allows cell attachment and cell infiltration, while the continuous layer acts as a barrier to infection, dehydration and cellular ingrowth. These properties are important if the material is to function as a dermal substitute. The two regions are expected to exhibit different rates of degradation in vivo, with the porous region being degraded quickly and the continuous region being degraded at a slower rate. The combination is both highly elastic and strong and could be used for a variety of tissue repair purposes. For example wound healing, bone repair, tendon repair, hernia repair, or bladder repair. In addition, the porous nature of the bottom layer and the film properties of the top layer may render the sheet materials particularly suitable as hemostats.
A further advantage of the thin integral bilayer structure of the invention is that the porous layer makes the sheet opaque. This solves a customer need for an opaque film for re-epithelization. Clinicians prefer wound dressing films to be opaque, rather than transparent, as the material then has an appearance similar to the dermis.
Suitably, the thickness of the layer of entrapped gas bubbles is from about 10% to about 90% of the thickness of the sheet, for example from about 25% to about 75% of the thickness of the sheet and typically about 50% of the thickness of the sheet.
Suitably, the entrapped gas bubbles occupy from about 10% to about 95% of the volume of the layer of entrapped gas bubbles, for example from about 30% to about 75% of the layer. It follows that the entrapped gas bubbles occupy from about 1% to about 85% of the volume of the sheet, suitably from about 5% to about 60% of the volume of the sheet. Suitably, the density of the sheet is from about 99% to about 15%, suitably from about 80% to about 50% of the theoretical density of a solid sheet of the protein matrix without entrapped gas bubbles.
Suitably, the mean diameter of the entrapped gas bubbles (as measured by the method of Procedure 1 below) is from about 25 micrometers to about 1 mm, for example from about 50 micrometers to about 500 micrometers. The resulting small pore sizes allow for a better surface area for cell attachment and allow for better mechanical strength and maintenance of structural integrity. Providing the pore size is greater than that of the diameter of the migrating cell (typically about lOμm) the smaller the pore size, the better for tissue ingrowth. The optimal pore size for the regeneration of skin is thought to be about 20 to about 150μm, while the optimum pore size for regeneration of bone is about 100 to about 400 μm, and for osteoid ingrown is about 40 to about lOOμm.
The gas bubbles suitably contain air, or an inert gas such as nitrogen or argon.
It is an advantage of the present invention that the thickness of the sheet can be controlled over a wide range. Suitably, the total thickness of the sheet is from about 0.1mm to about 10mm, preferably from about 0.5mm to about 5mm. For certain uses such as re-epithelisation, thinner sheets may be preferable. For other tissue repair purposes, such as tissue infilatration, hernia repair or hemostasis, thicker sheets are preferred.
The protein matrix comprises a major fraction of one or more proteins. That is to say, more than about 50%, preferably at least about 75%, and more preferably at least about
90% of the solid components of the matrix by weight consists of one or more proteins. It is thought that a wide range of purified or freeze-dried or powdered medically acceptable proteins could be used. Suitable medically acceptable proteins for making the matrix include naturally occurring structural proteins such as collagen, elastin, fibronectin, laminin, fibrin, tenascin, vitronectin, keratins (methods to solubilize keratins are known), as well as other proteins of the human connective tissue matrix. Other suitable proteins include serum proteins such as albumin and globulins. Whey proteins can also be used, and may also have beneficial effects on healing. Proteins that are water-soluble before cross-linking, but that can be made substantially insoluble by cross-linking as described below, are preferred. In addition, fragments or peptides derived form the above- identified naturally occurring proteins could be used.
A suitable protein for forming the matrix is collagen. The collagen may be any collagen, including Type I or Type II or Type III collagen, natural fibrous collagen, atelocollagen, partially hydrolysed collagens such as gelatin, and combinations thereof. Type IV collagen could also be incorporated as this is component of basal membrane and may aid would healing. Recombinant human collagen, for example as described in US-A- 5962648 and WO-A-2004078120 may be used. Natural collagen, for example of bovine origin, is suitable. Suitably, the protein matrix comprises a dehydrothermally crosslinked collagen. Preferably, the protein is not succinylated.
In addition to the protein, the matrix may comprise a minor amount of one or more medically acceptable polymers other than proteins. The term "minor amount" implies that the other medically acceptable polymers are present in an amount of less than about 40% of the solid components of the matrix, preferably less than about 25%, for example about 1% to about 25% by weight. The medically acceptable polymers may for example be selected from polyurethanes, biopolymers, carboxymethyl celluloses, hydroxyethyl celluloses, hydroxy propyl methyl celluloses, modified acrylamides and mixtures thereof. Suitable biopolymers include alginates, pectins, galactomannans, chitosan, gelatin, hyaluronates and mixtures thereof. Some of these biopolymer materials also promote wound healing.
Suitable plasticisers include low molecular weight hydrophilic materials. The
plasticizers should preferably be liquids at room temperature (about 25°C). The plasticizers may comprise lipids or fatty alcohols. Preferred plasticisers include polyhydric alcohols such as glycols and sugar alcohols, since these plasticizers also function as humectants. Suitable glycols include glycerol, propylene glycol and low molecular weight polyethylene glycols generally having molecular weights below 600. Suitable sugar alcohols include sorbitol. These may be used alone or in mixtures. Suitably, the amount of plasticizer in the matrix composition is from about 2wt.% to about 50wt.%, preferably from about 5wt.% to about 25wt.% based on the weight of the matrix. The amount of plasticizer is chosen to provide a sheet that is flexible, conformable, continuous and elastic while still forming a solid after crosslinking and drying. The weight ratio of plasticiser to total protein will depend on whether protein is inherently soluble (e.g serum proteins) or structural (gelatin or collagen). The weight ratio of plasticizer to total protein is suitably from about 2:1 to about 1 :10, preferably from about 1:1 to about 1:5. For example, a range of about 1:1 to about 3:2 ( plasticizer to protein) was best for gelatin. A ration of about 1 :2 to about 1 :5 was best for albumin.
The addition of the plasticizer results in a flexible, continuous, elastic protein matrix. Suitably, the sheet materials according to the present invention have an elongation at break greater than about 100% when measured by the method of Procedure 2 below.
The sheet materials according to the present invention are suitably substantially insoluble in water at physiological pH of about 6 to about 8 and physiological temperatures of about 40°C. The low solubility of the sheet materials may be achieved by cross-linking the protein after formation of the sheet. The cross-linking may be chemical cross-linking, for example by treatment with hexamethylene diisocyanate (HMDI) or glutaraldehyde. However, chemical cross-linking may give rise to antigenicity of the materials, and therefore the cross-linking may preferably be so-called dehydrothermal cross-linking achieved by drying the sheet materials at elevated temperatures, e.g. temperatures above about 50°C, preferably temperatures above 80°C.
The sheet materials according to the present invention are suitably fully biodegradable and resorbable in vivo. This can usually be achieved by appropriate selection of the
protein, since wound fluids contain a range of protease enzymes. For example, collagen, gelatine and albumin are fully biodegradable and resorbable in vivo.
The sheet materials according to the present invention are suitably substantially dry. In certain embodiments, they may comprise up to about 20% by weight, preferably from about 2% to about 10% by weight of water.
In certain embodiments, the sheet materials according to the present invention may also comprise up to about 10% by weight, for example from about 0.01 to about 5% by weight, typically from about 0.1 to about 2% by weight of one or more wound healing therapeutic agents, such as non-steroidal anti-inflammatory drugs (e.g. acetaminophen), steroids, local anaesthetics, antimicrobial agents, cytokines or growth factors. The antimicrobial agent may, for example, comprise an antiseptic, an antibiotic, or mixtures thereof. Preferred antibiotics include tetracycline, penicillins, terramycins, erythromycin, bacitracin, neomycin, polymycin B, mupirocin, clindamycin and mixtures thereof. Preferred antiseptics include silver, including colloidal silver, silver salts (including salts of one or more anionic polymers such as ORC or alginate), silver sulfadiazine, chlorhexidine, povidone iodine, triclosan, sucralfate, quaternary ammonium salts and mixtures thereof. Preferably, the amount of silver (as silver ions and metallic silver) in the materials according to the present invention is from about 0.01wt% to about 2wt.%, more preferably from about 0.05wt% to about 0.5wt.%, and most preferably about 0.1wt.% to about 0.3wt.%. Lesser amounts of silver could give insufficient antimicrobial effect. Greater amounts of silver could give rise to antiproliferative effects on wound healing cells. The growth factors, where present, may comprise fibroblast growth factor (FGF), platelet derived growth factor (PDGF), epidermal growth factor (EGF), transforming growth factor alpha (TGF-alpha), transforming growth factor beta (TGF-beta), or combinations thereof. The sheet material may alternatively or additionally comprise fibronectin, which is thought to promote regeneration of the extracellular matrix in the wound.
In certain embodiments, especially for surgical applications, it may be desirable to reinforce the sheet materials according to the present inventions so that the sheets can be sutured.
Accordingly, in a further aspect, the present invention provides a sheet material comprising a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet and having a layer of a reinforcing material embedded in the matrix or bonded to a surface of the matrix.
Suitably, the matrix is reinforced by a layer of a synthetic bioabsorbable material. The layer may be in the form of a continuous or perforated sheet or web. Suitably, the layer is a mesh or a woven, nonwoven or knitted fabric. Preferred bioabsorbable polymers for forming the reinforcing mesh or fabric include suture materials such as copolymers of lactic acid and glycolic acid, or oxidised regenerated cellulose. A particularly preferred synthetic bioabsorbable polymer is the polylactic/polyglycolic acid copolymer sold under the Registered Trade Mark VICRYL. Also particularly preferred is the oxidised regenerated cellulose mesh sold under the Registered Trade Mark SURGICEL.
Suitably, the structure and composition of the protein matrix are as described above in relation to the first aspect of the invention. Suitably, the sheet material according to the present invention is sterile and packaged in a microorganism-impermeable container.
In a further aspect, the present invention provides a wound dressing comprising a sheet material according to the present invention.
The wound dressing may consist essentially of the sheet material according to the invention, or it may further comprise additional layers. The sheet material according to the invention would normally be the wound contacting layer of the dressing in use, and the surface of the sheet containing the entrapped bubbles would normally be the wound facing surface. Preferably, the area of the layer of sheet material according to the invention in the wound dressing is from about lcm2 to about 400 cm2, more preferably from about 4cm to about 100cm .
In certain embodiments, the wound dressing further comprises a backing sheet extending over the sheet material opposite to the wound facing side of the sheet material. Preferably, the backing sheet is larger than the sheet material according to the invention
such that a marginal region of width lmm to 50mm, preferably 5mm to 20mm extends around the sheet material to form a so-called island dressing. In such cases, the backing sheet is preferably coated with a pressure sensitive medical grade adhesive in at least its marginal region.
Suitably, the backing sheet is substantially liquid-impermeable. The backing sheet is preferably semipermeable. That is to say, the backing sheet is preferably permeable to water vapour, but not permeable to liquid water or wound exudate. Preferably, the backing sheet is also microorganism-impermeable. Suitable continuous conformable backing sheets will preferably have a moisture vapor transmission rate (MVTR) of the backing sheet alone of 300 to 5000 g/m2/24hrs, preferably 500 to 2000 g/ni2/24hrs at 37.5 °C at 100% to 10% relative humidity difference. The backing sheet thickness is preferably in the range of 10 to 1000 micrometers, more preferably 100 to 500 micrometers. It has been found that such moisture vapor transmission rates allow the wound under the dressing to heal under moist conditions without causing the skin surrounding the wound to macerate.
Suitable polymers for forming the backing sheet include polyurethanes and poly alkoxyalkyl acrylates and methacrylates such as those disclosed in GB-A-1280631. Preferably, the backing sheet comprises a continuous layer of a high density blocked polyurethane foam that is predominantly closed-cell. A suitable backing sheet material is the polyurethane film available under the Registered Trade Mark ESTANE 5714F.
The adhesive (where present) layer should be moisture vapor transmitting and/or patterned to allow passage of water vapor therethrough. The adhesive layer is preferably a continuous moisture vapor transmitting, pressure-sensitive adhesive layer of the type conventionally used for island-type wound dressings, for example, a pressure sensitive adhesive based on acrylate ester copolymers, polyvinyl ethyl ether and polyurethane as described for example in GB-A-1280631. The basis weight of the adhesive layer is preferably 20 to 250 g/m2, and more preferably 50 to 150 g/m2. Polyurethane-based pressure sensitive adhesives are preferred.
Further layers of a multilayer absorbent article may be built up between the protein sheet material and the protective backing sheet. For example, these layers may comprise an absorbent layer between the protein sheet and the backing sheet, especially if the dressing is for use on exuding wounds. The optional absorbent layer may be any of the layers conventionally used for absorbing wound fluids, serum or blood in the wound healing art, including hydrophilic foams, gauzes, nonwoven fabrics, superabsorbents, hydrogels and mixtures thereof. The basis weight of the absorbent layer may be in the range of 50-500g/m2, such as 100-400g/m2. The uncompressed thickness of the absorbent layer may be in the range of from 0.5mm to 10mm, such as lmm to 4mm. The free (uncompressed) liquid absorbency measured for physiological saline may be in the range of 5 to 30 g/g at 25°. Preferably, the absorbent layer or layers are substantially coextensive with the active layer.
The wound facing surface of the dressing may be protected by a removable cover sheet. The cover sheet is normally formed from flexible thermoplastic material. Suitable materials include polyesters and polyolefms. Preferably, the adhesive- facing surface of the cover sheet is a release surface. That is to say, a surface that is only weakly adherent to the protein sheet material and the adhesive on the backing sheet to assist peeling of the adhesive layer from the cover sheet. For example, the cover sheet may be formed from a non-adherent plastic such as a fluoropolymer, or it may be provided with a release coating such as a silicone or fluoropolymer release coating.
Typically, the wound dressing according to the present invention is sterile and packaged in a microorganism-impermeable container.
In a further aspect, the present invention provides a method of manufacture of a protein sheet material comprising the steps of: dispersing a protein in a solvent to form a liquid dispersion; dispersing gas bubbles in the liquid dispersion; spreading the liquid dispersion containing the dispersed gas bubbles to form a sheet thereof; allowing the gas bubbles to rise towards the top of said sheet to form distinct foamed and unfoamed layers in the sheet; crosslinking the protein in the foamed dispersion sheet; and drying the foamed dispersion sheet.
Suitably, the dimensions of the bubbles and the relative dimensions of the foamed and unfoamed layers are substantially as described above in relation to the sheet materials of the invention.
Suitably, the solvent is an aqueous solvent, and preferably it is water. The solvent may be acidified, for example to a pH less than about 5, for example to achieve swelling and gelation of dispersed collagen. Other components of the sheet material as hereinbefore described may be dispersed in the solvent before or after dispersion of the protein. The protein may be any of the proteins hereinbefore described in relation to the sheet materials of the invention. Suitably, the protein is a soluble in the solvent, in which case the dispersion is a solution. The concentration of the protein in the solvent is suitably adjusted to produce a dispersion of moderate viscosity, whereby bubbles formed in the dispersion separate into a distinct layer in a relatively short time, but the viscosity is not so low that the bubbles escape from the solution completely before the drying and cross linking are complete. Typical protein concentrations in the dispersion are from about 1% by weight to about 50% by weight, for example from about 10% by weight to about 30% by weight, based on the weight of the dispersion. If a concentrated protein solution is used and the viscosity is to great to mix to get solubilization or to get a froth, then mild warming of the solution may be beneficial to reduce the viscosity.
The step of foaming the liquid dispersion may be carried out by shaking, whisking or by gas injection. Preferably, the dispersion is substantially free of surfactants or other added foaming agents, whereby the formation of larger bubbles in the dispersion is avoided.
The step of spreading the foamed dispersion may be performed by any conventional method, such as by pouring the dispersion into a tray mold or spreading the dispersion onto a suitable release surface. The mold or release surface may be profiled, for example with an array of projections, in order to produce a sheet having a profiled bottom (i.e. substantially non-porous) surface. Suitable profiled mold surfaces are described, for example, in WO2004/052414. Where a reinforced sheet material is desired, the foamed dispersion may be cast or spread onto a layer of the reinforcing mesh as hereinbefore described, and allowed to penetrate into the mesh. The dispersion may
be left for a suitable time after spreading to allow the bubbles in the dispersion to separate into a distinct layer in the top of the dispersion layer.
The step of crosslinking may be carried out before, after, or simultaneously with the step of drying. Chemical crosslinking may be achieved by the use of conventional crosslinking agents such as glutaraldehyde or HMDL Suitably, the steps of crosslinking and drying are performed simultaneously in a dehydrothermal crosslinking step. For example, the dehydrothermal crosslinking step is suitably carried out at a temperature of at least about 50°C, typically at a temperature of about 60°C to about 150°C, for example at a temperature of about 80°C to about 100°C. The time of heating will be dependent on the thickness of the material being prepared. Preferably, the step of drying is carried out at substantially atmospheric pressure, i.e. not under substantially reduced pressure as in lyophilisation.
It can be seen that an advantage of the invention is the ease and simplicity of manufacture. The basic bilayer sheet structure can be made with a protein, plasticizer and water. The thickness of the sheet and the relative thicknesses of the porous and continuous layers can readily be controlled. Importantly, no chemical crosslinking reagents, solvents, surfactants, or freeze-drying steps are required.
Suitably, the method according to the present invention is adapted for the preparation of a sheet material according to the present invention.
It will be appreciated that any feature or embodiment that is described herein in relation to any one aspect of the invention may also be applied in relation to any other aspect of the invention.
Certain embodiments of the present invention will now be described further in the following examples, and by reference to the accompanying drawings, in which: Figure 1 shows a cross-sectional view through a portion of protein sheet material according to the present invention;
Figure 2 shows a cross-sectional view through a portion of a reinforced protein sheet material according to the present invention; and
Figure 3 shows a perspective view of a wound dressing according to the present invention.
Referring to Fig. 1, the sheet 1 comprises a plasticized collagen matrix comprising a continuous layer 2 on one side thereof, and a layer 3 of entrapped gas bubbles 4 on the other side thereof.
Referring to Fig. 2, the reinforced sheet 5 comprises a plasticized collagen matrix comprising a continuous layer 7 on one side thereof, and a layer 6 of entrapped gas bubbles on the other side thereof. A reinforcing layer 8 of SURGICEL (Registered Trade Mark) oxidized regenerated cellulose fabric is embedded in the continuous gel layer 7.
Referring to Fig. 3, the wound dressing 10 is an island-type, self-adhesive wound dressing comprising a backing layer 12 of microporous liquid-impermeable polyurethane foam, such as ESTANE 5714F (Registered Trade Mark). The backing layer 12 is permeable to water vapor, but impermeable to wound exudate and microorganisms.
The backing layer is coated with a substantially continuous layer of pressure-sensitive polyurethane adhesive. An island 11 of the sheet material according to the present invention is adhered to a central region of the adhesive-coated backing sheet 12 such that an adhesive-coated margin 13 of the backing sheet extends around the island for attachment of the dressing to the skin around a wound. The island is adhered to the backing sheet by the continuous face thereof, whereby the porous face of the sheet according to the invention faces the wound in use.
Protective release-coated cover sheets 14,15 are provided as shown in Fig. 3. These cover sheets are removed immediately before use of the dressing.
Example 1: Albumin Sheet
40% (w/w) albumin (Sigma A4503), 10% (w/w) glycerol and 50% water
The glycerol was added to the water and then the albumin was added slowly with constant mixing until a viscous solution was formed (this solution was named B). The mixture was frothy and was poured into a 100 mm square petri dish (Sterilin). About 15-20 ml was poured. The sample was placed (without lid) in an oven at 8O0C for lhr.
This process resulted in the formation of an albumin sheet having a bilayer structure, i.e. a continuous gel layer on one side and a foamed layer comprising entrapped air bubbles on the other side.
Example 2: Albumin + ORC + Collagen
20ml of solution B (see example 1 above) was added to 2.1 g of an ORC/collagen aqueous slurry (1.3% solids; pH3; ORCxollagen weight ratio of 45:55) prepared as described in Example 1 of EP-A-1153622. The solution was mixed to form a froth, poured and dried at 800C for lhr.
Flexible layered sheet structures similar to those of Example 1 resulted. This dressing sheet material should provide additional advantages, since ORC is known to have hemostatic properties, and the combination of ORC with collagen is especially effective for inactivating undesirable protease enzymes in wound fluid.
Example 3: Albumin + fibronectin
A stock solution was prepared from the following components: 34% (w/w) albumin (Sigma A4503), 12% (w/w) glycerol (Sigma G6279) and 56% (w/w) water.
15ml of the stock solution was mixed with 150μl of Fibronectin (stock lmg/ml). This was mixed to form a frothy mixture and poured. The fibronectin concentration in the solution was therefore ~100μg/ml. The material was dried at 8O0C for about 1.25hr
Layered sheet structures similar to those of Example 1 were produced using the above procedure. It is expected that the presence of fibronectin in the sheet material will promote the regeneration of the extracellular matrix in wounds.
Example 4: Gelatin Sheet
Composition: 10% gelatin (Fluka 48723); 15% glycerol (Sigma G6279); 75% water.
The glycerol was added to 75g of water and mixed. 10 g of gelatin was slowly added to the mixture with constant stirring.
The mixture was heated to about 400C during mixing to allow the gelatin to go into solution more rapidly. 20ml was then removed and placed into a clean 50ml Falcon tube. The material was shaken for 2 minutes to produce a froth that was poured in a
Petri dish and dried for 2 hrs at 8O0C.
Layered sheet structures similar to those of Example 1 were produced using the above procedure.
Example 5: Gelatin- Fibronectin Sheets
A stock solution was prepared containing 10% (w/w) gelatin, 15 % glycerol and 75% glycerol.
30ml of this stock solution and 300μl Fibronectin (lmg/ml) (Sigma Fl 141) was added. The sample was poured into a Petri dish and dried in an oven for 90 min at 8O0C.
Layered sheet structures similar to those of Example 1 were produced using the above procedure.
The concentration of fibronectin incorporated (50micrograms/ml) is known to promote cell attachment. The inclusion of fibronectin was found not to affect the structure.
Procedure 1: Measurement of pore size
Sheet materials according to the invention were cut into small strips (3mm wide and viewed down a Nikon Eclipse TE2000 microscope (x2 magnification). Lengths were calibrated (in mm) using the microscope calibration tool in the Lucia G software. Linear distances were determined for a) Total thickness of bilayer; b) thickness of film layer; c) thickness of foam (porous) layer and d) diameter of pores.
Table 1 Sheet 10 (10% glycerol, 10% gelatin)
Table 2
Sheet 11 (15% glycerol, 10% gelatin)
Table 3
Sheet 12 (10% glycerol, 10% gelatin)
The average pore size of the three samples was 106±50μm (sample 10), 55±21μm (sample 11) and 104± 68μm (sample 12).
The small pore sizes allow for a better surface area for cell attachment and allow for better mechanical strength and maintenance of structural integrity. Providing the pore size is greater than that of the diameter of the migrating cell (typically lOμm) the smaller the pore size the better for tissue in growth. The optimal pore size for the regeneration of skin is thought to be 20-15 Oμm, while the optimum pore size for regeneration of bone is 100-400um, and for osteoid ingrown is 40-100μm. From the data shown here the sheet materials according to the present invention should be well suited for many types of tissue repair.
Procedure 2: Tensile Strength
To measure the elasticity and strength of the sheet materials a break tensile test was carried out as follows. Briefly, the sheet was cut, with a scalpel, into 5cm x lcm (width) strips. The material was placed in the load cell of an Instron 5544 and the breaking load, load at 20% extension and the break elongation measured at a pull sped of 200mm/min. The results are shown in Table 4.
Table 4
These data shows the material is both strong and highly elastic. These properties suggest that the material may be suitable for many medical and surgical applications.
The above embodiments have been described by way of example only. Many other embodiments falling within the scope of the accompanying claims will be apparent to the skilled reader.
Claims
1. A sheet material consisting essentially of a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet.
2. A sheet material according to claim 1, wherein the thickness of the layer of entrapped gas bubbles is from about 25% to about 75% (maybe increase this range) of the thickness of the sheet.
3. A sheet material according to any preceding claim, wherein the entrapped gas bubbles occupy from about 10% to about 95% of the volume of said layer.
4. A sheet material according to any preceding claim, wherein the median diameter of the entrapped gas bubbles is from about 25 micrometers to about 1 mm.
5. A sheet material according to any preceding claim, wherein the thickness of the sheet is from about lmm (reduce-see earlier comments to about 5mm.
6. A sheet material according to any preceding claim, wherein the protein matrix comprises a dehydrothermally crosslinked protein.
7. A sheet material comprising a continuous, plasticized protein matrix incorporating entrapped gas bubbles in a layer adjacent to one surface only of the sheet and having a layer of a reinforcing material embedded in the matrix or bonded to a surface of the matrix.
8. A wound dressing comprising a sheet material according to any preceding claim.
9. A method of manufacture of a protein sheet material comprising the steps of: dispersing a protein in a solvent to form a liquid dispersion; dispersing gas bubbles in the liquid dispersion; spreading the liquid dispersion containing the dispersed gas bubbles to form a sheet thereof; allowing the gas bubbles to rise towards the top of said sheet to form distinct foamed and unfoamed layers in the sheet; crosslinking the protein in the foamed dispersion sheet; and drying the foamed dispersion sheet.
10. A method according to claim 9, wherein the steps of crosslinking and drying are performed in a dehydrothermal crosslinking step.
11. A method according to claim 9 or 10, for the preparation of a sheet material according to any of claims 1 to 7.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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GB0623965.1 | 2006-11-30 | ||
GB0623965A GB2444323B (en) | 2006-11-30 | 2006-11-30 | Protein sheet material |
Publications (2)
Publication Number | Publication Date |
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WO2008065329A2 true WO2008065329A2 (en) | 2008-06-05 |
WO2008065329A3 WO2008065329A3 (en) | 2009-01-08 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/GB2007/004033 WO2008065329A2 (en) | 2006-11-30 | 2007-10-23 | Protein sheet material |
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GB (1) | GB2444323B (en) |
WO (1) | WO2008065329A2 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2019171215A1 (en) * | 2018-03-05 | 2019-09-12 | Ethicon Llc | Sealant foam compositions for lung applications |
Citations (5)
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US3800792A (en) * | 1972-04-17 | 1974-04-02 | Johnson & Johnson | Laminated collagen film dressing |
US4555417A (en) * | 1980-07-30 | 1985-11-26 | A. E. Staley Manufacturing Company | Method for coating a substrate with a foamed proteinaceous product |
WO2001062312A1 (en) * | 2000-02-25 | 2001-08-30 | Monterey Biomedical, Inc. | Foam-forming wound dressing |
US20020111576A1 (en) * | 2000-12-29 | 2002-08-15 | Kimberly-Clark Worldwide, Inc. | Bioabsorbable wound dressing |
EP1284106A2 (en) * | 2001-08-16 | 2003-02-19 | Campina B.V. | Method for preparing an edible stable foam, foam and foodstuff wich comprises the foam |
Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CH625702A5 (en) * | 1977-01-18 | 1981-10-15 | Delalande Sa | |
GB1602340A (en) * | 1977-06-09 | 1981-11-11 | Pikok Ind Trading Co | Skin dressings |
JPS60156354A (en) * | 1983-12-17 | 1985-08-16 | Yoshihara Seiyu Kk | Soybean protein film |
GB0223835D0 (en) * | 2002-10-12 | 2002-11-20 | Eastman Kodak Co | Method of making a material |
DE102004024635A1 (en) * | 2004-05-12 | 2005-12-08 | Deutsche Gelatine-Fabriken Stoess Ag | Process for the preparation of moldings based on crosslinked gelatin |
-
2006
- 2006-11-30 GB GB0623965A patent/GB2444323B/en not_active Expired - Fee Related
-
2007
- 2007-10-23 WO PCT/GB2007/004033 patent/WO2008065329A2/en active Application Filing
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3800792A (en) * | 1972-04-17 | 1974-04-02 | Johnson & Johnson | Laminated collagen film dressing |
US4555417A (en) * | 1980-07-30 | 1985-11-26 | A. E. Staley Manufacturing Company | Method for coating a substrate with a foamed proteinaceous product |
WO2001062312A1 (en) * | 2000-02-25 | 2001-08-30 | Monterey Biomedical, Inc. | Foam-forming wound dressing |
US20020111576A1 (en) * | 2000-12-29 | 2002-08-15 | Kimberly-Clark Worldwide, Inc. | Bioabsorbable wound dressing |
EP1284106A2 (en) * | 2001-08-16 | 2003-02-19 | Campina B.V. | Method for preparing an edible stable foam, foam and foodstuff wich comprises the foam |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2019171215A1 (en) * | 2018-03-05 | 2019-09-12 | Ethicon Llc | Sealant foam compositions for lung applications |
US10980913B2 (en) | 2018-03-05 | 2021-04-20 | Ethicon Llc | Sealant foam compositions for lung applications |
Also Published As
Publication number | Publication date |
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WO2008065329A3 (en) | 2009-01-08 |
GB2444323A (en) | 2008-06-04 |
GB2444323B (en) | 2011-04-06 |
GB0623965D0 (en) | 2007-01-10 |
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