WO2017093528A1 - Textured surfaces for implants - Google Patents
Textured surfaces for implants Download PDFInfo
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- WO2017093528A1 WO2017093528A1 PCT/EP2016/079659 EP2016079659W WO2017093528A1 WO 2017093528 A1 WO2017093528 A1 WO 2017093528A1 EP 2016079659 W EP2016079659 W EP 2016079659W WO 2017093528 A1 WO2017093528 A1 WO 2017093528A1
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- contacting
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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
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
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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
- A61F2/02—Prostheses implantable into the body
- A61F2/12—Mammary prostheses and implants
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- 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
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/28—Materials for coating prostheses
- A61L27/34—Macromolecular materials
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- 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
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
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- G—PHYSICS
- G03—PHOTOGRAPHY; CINEMATOGRAPHY; ANALOGOUS TECHNIQUES USING WAVES OTHER THAN OPTICAL WAVES; ELECTROGRAPHY; HOLOGRAPHY
- G03F—PHOTOMECHANICAL PRODUCTION OF TEXTURED OR PATTERNED SURFACES, e.g. FOR PRINTING, FOR PROCESSING OF SEMICONDUCTOR DEVICES; MATERIALS THEREFOR; ORIGINALS THEREFOR; APPARATUS SPECIALLY ADAPTED THEREFOR
- G03F1/00—Originals for photomechanical production of textured or patterned surfaces, e.g., masks, photo-masks, reticles; Mask blanks or pellicles therefor; Containers specially adapted therefor; Preparation thereof
- G03F1/38—Masks having auxiliary features, e.g. special coatings or marks for alignment or testing; Preparation thereof
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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
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
- A61F2002/0081—Special surfaces of prostheses, e.g. for improving ingrowth directly machined on the prosthetic surface, e.g. holes, grooves
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0071—Three-dimensional shapes spherical
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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
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
-
- 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
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
- A61F2240/002—Designing or making customized prostheses
- A61F2240/004—Using a positive or negative model, e.g. moulds
-
- 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
- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
- A61F2240/005—Templates
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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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0025—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in roughness
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0037—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in height or in length
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- 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
- A61L2400/00—Materials characterised by their function or physical properties
- A61L2400/18—Modification of implant surfaces in order to improve biocompatibility, cell growth, fixation of biomolecules, e.g. plasma treatment
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- 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
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/04—Materials or treatment for tissue regeneration for mammary reconstruction
Definitions
- This invention relates to biocompatible implant materials having textured surface topographies for reducing an undesirable cellular response upon implantation into the body and subsequent capsular contracture formation, with particular application to prosthetic implants, such as silicone breast implants.
- prosthetic implants such as silicone breast implants.
- Methods for preparing such surfaces, and templates useful for preparing such surfaces are also disclosed.
- Implant based surgery is performed in a variety of settings, from reconstruction for congenital anomalies and post mastectomy defects for oncological reasons, to augmentations for cosmetic reasons.
- currently available breast implants are not without their innate complications.
- the most common complication and cause for patient dissatisfaction post implantation is capsular contracture formation.
- (1 ) 1 ,773,584 breast augmentations for aesthetic reasons were declared worldwide to the International Society of Aesthetic Plastic Surgery in 2014.(2) Capsular contracture rates have been speculated to occur in as many as 17.5% of implant based procedures, and therefore a significant number of these women will have experienced capsular contracture.
- Capsular contracture is the exaggeration of foreign body response of the patient's breast tissue to the breast implant.
- Capsular contracture has been shown to be multifactorial, with filler material, sub-muscular placement of the implant, adjuvant radiotherapy, bacterial colonisation of the implant and implant surface texture all being implicated in its development. (6)
- Micro and nano surface topographies have been shown to influence cell proliferation, attachment, adhesion, migration and morphology.
- Many of the morphological topographies which exist in vivo which interact with cells are those from the extra cellular matrix (ECM) and it has been shown that the ECM of different tissue types promote the production of tissue morphologies from where they are derived.
- Implant textures have also been theorised to reduce contracture by disrupting the planar capsule which surrounds the implant and promoting the ingrowth of breast tissue.
- deep “macro-textures”, with deep surface features have also been shown to shed particulate silicone and increase the inflammation within implant capsules.
- implant surfaces may have a primary surface profile made up of the surface form, which is the general shape of the material surface.
- the surface of a breast implant will generally adopt a curved form, perhaps with additional contours / waves which may be natural features / undulations that form as a result of the physical make-up of the implant.
- the way in which such surfaces interact with body tissue at a cellular level is however better described by reference to the surface roughness, which refers to the topographical texture of the primary implant surface on a smaller scale.
- Breast implants are typically formed by dipping an implant-shaped template (mandrel) into liquid polymer so that it becomes uniformly coated.
- the implant Prior to curing, the implant can be subjected to a texturizing process such as imprinting on a mould to create a patterned texture in silicone (e.g. Mentor SiltexTM Implant).
- a texturizing process such as imprinting on a mould to create a patterned texture in silicone (e.g. Mentor SiltexTM Implant).
- the mandrel is then placed in a hot, laminar flow cabinet to allow for the polymer to solidify around the template (curing).
- This curing step allows for an equal amount of heat to be applied around the implant so that a homogenous surface is created.
- This process can be repeated several times to increase the thickness of the implant and the implant may then be further treated with a solvent if it is to be smooth (to further smooth out the surface).
- Silicone breast implants are thus typically made through this same basic process, regardless of whether they are designed to be smooth or textured.
- implant surfaces that are "smooth” do in fact usually exhibit an unintentional minor degree of surface roughness as a result of fine ripples, grooves and / or other surface anomalies that are an inherent bi-product of the process by which the surfaces are prepared (for instance forming during the curing process as the liquid silicone trickles down the mandrel under force of gravity).
- textured surfaces typically comprise a heavily textured surface topography. Such textures may be regular repeating geometric patterns or may be irregular in nature.
- WO2009/046425 for example describes textured implant surfaces having a highly ordered regular geometric repeating pattern (parallel bars) at the micro- or nano-scale which are claimed to disrupt bacterial biofilm formation on the implant surface.
- the repeating pattern is formed by production of a master pattern using photolithographic techniques as applied in semiconductor manufacture and the master pattern is then used to contact print replicated patterns on the surface of the implant.
- conventional photolithographic techniques can provide simple geometric structures such as the grooves depicted in WO2009/046425, such methods are not attractive when more complex geometric patterns are sought because such patterns depend on the preparation and use of photo-masks with graded levels of opacity through which graded levels of UV light may pass onto the photoresist.
- Such photo-masks are expensive to produce and cannot be altered once produced, meaning that each desired design / pattern requires the prior preparation of bespoke photo-masks.
- WO95/03752 also depicts an implant surface having a highly ordered regular geometric repeating pattern (pillars).
- These uniform micro-textured surfaces may be produced by use of ion-beam thruster technology (see e.g. page 2 of WO95/03752).
- ion-beam thruster technology see e.g. page 2 of WO95/03752.
- implant surfaces typically lead to the orientation of fibroblasts in conformity with the respective surface pattern (see e.g. paragraphs 28, 34 and figures 14 and 15 of WO2009/046425).
- the organised orientation of fibroblasts and, subsequently, collagen is understood to be a key stage in the promotion of fibrotic capsule contracture.
- such ordering of fibroblast might be more acceptable in external applications such as for use in wound healing, such highly ordered patterned surfaces are not therefore ideal for use in prosthetic implants, such as breast implants, which are prone to capsule formation and contracture.
- An alternative technique for forming an open-cell structure involves the use of an open cell foam or fibrous polymeric fabric to either form or imprint a pattern on the implant surface.
- an open cell foam or fibrous polymeric fabric For instance, the commercially available SiltexTM implant (Mentor), uses a mandrel with a polyurethane foam texture that is imprinted into the silicone during curing. Similar fabric / open cell foam-based texturizing techniques are also described in US 201 1/0276134, WO 201 1/097499 and US2002/01 19177. If such open cell-like structures are achieved using a fabric with a uniform geometry, then open-cell structures with small-scale irregularity but longdistance uniformity may be achieved (see e.g. Figure 10 and 12 of US 201 1/0276134).
- WO95/03752 discloses an alternative method for producing irregular surface topographies in silicone breast implants by adding filtered silicone particles to the still tacky surface of the mandrel before curing and application of a top-coat (pages 10 to 12).
- WO2015/1216866 having inventors in common with the present application, proposes an irregular textured surface modelled on the basement membrane of the skin, the specific characteristics of the basement membrane being such as to impart the synthetic surface with corresponding characteristic values for mean surface roughness Sa, root mean square height Sq, maximum peak height to trough depth Sz, mean surface skewness Ssk, mean excess kurtosis value (Sku minus 3), and fractal dimension.
- the inventors propose new biomimetic textured surface topographies for implants, particularly breast implants.
- the inventors have found in particular that by controlling aspects of the surface texture to resemble corresponding features of the surface topography of adipose tissue improved cellular response, indicative of reduced capsular contraction, and appropriate cellular anchoring / in-growth could be achieved.
- the inventors sought to produce an implant topography with a provenance from the breast, specifically adipose tissue from the breast.
- the inventors have employed site-specific biomimicry to generate a novel implant surface that is adapted to its intended implant site.
- site-specific biomimicry to generate a novel implant surface that is adapted to its intended implant site.
- the inventors isolated adipose tissue from the adipose tissue interface, conducted a series of fixation techniques, characterised it using imaging techniques, modelled it with bespoke image analysis, and generated a synthetic replica of the observed adipose tissue surface using 3D photolithography.
- the present invention provides an implant material having an implant surface, which implant surface comprises a plurality of tissue-contacting members arranged in a regular or irregular two-dimensional array, each tissue-contacting member having a convex curved tissue-contacting surface.
- adipose tissue surface that, when reproduced on the surface of an implant, may contribute to improved cell response and reduced capsular contracture.
- one or more of the following surface features can be reproduced on the implant surface: the approximately hemispherical form of the adipose cells that form the surface of the adipose tissue (against which the implant will be placed); the close packing of the adipose cells on the surface (which close packing effectively truncates the hemispheres, causing them to appear to fuse together); the density of cells (cells per unit area), that being related to the close packing; the average size (diameter) of the adipose cells (in turn dictating the radius of curvature that the cells present at the surface); the distribution or variance in size (diameter); the average spacing between adjacent cells (nearest neighbour distance); the distribution or variance in spacing between adjacent cells (nearest neighbour distance); the surface coverage of the cells (extent to which the tissue
- an adipose tissue-like surface on the implant may permit the implant to tessellate with or pack into the adipose tissue of the breast.
- the biomimetic topography suitably provides an environment for cells that is less likely than conventional implant surfaces to cause foreign body response and especially capsular contracture.
- the implant surface of the implant material of the invention seeks to mimic one or more of the characteristics of the adipose tissue surface that has been carefully characterised by the inventors.
- the tissue-contacting members of the implant surface correspond to the adipose cells that provide the adipose surface topography.
- a characteristic of the adipose tissue surface is the array of approximately (part) hemispherical shapes - a globular form, and so the tissue-contacting members of the implant surface have a convex (that is, extending outwardly/away from the surface) curved tissue-contacting surface.
- the provision of an array of such convex curved surfaces mimics the multiple curved surfaces arising from the close packing of the adipose cells.
- the convex curved tissue-contacting surface has a radius of curvature for which the radius is approximately constant. That is, the curvature is approximately spherical curvature.
- the convex curved tissue-contacting surface corresponds to a portion of the surface of a sphere.
- the convex curved tissue-contacting surface corresponds to a substantial part of the (curved) surface of a hemisphere.
- each tissue-contacting member has the shape of part of or all of a hemisphere.
- each tissue-contacting member, or at least its convex curved tissue-contacting surface has a globular shape.
- the tissue-contacting members suitably have the shape of part or all of a globe. That is they are, or form part of, a globule.
- the tissue-contacting members can be protuberances, nodules, raised dimples or globule such that the implant surface has a two dimensional array of protuberances, nodules or raised dimples.
- each of the protuberances, nodules, raised dimples or globule provides a convex curved tissue-contacting surface such that the cumulative effect of the array of such curved surfaces is to mimic the topography of the adipose tissue surface.
- the tissue-contacting members suitably have the shape of part of or all of a hemisphere.
- the inventors believe that the hemisphere is the shape that provides closest match to the native adipose tissue surface.
- the height of the tissue-contacting members suitably corresponds to the height of a hemisphere having a radius of curvature corresponding to the radius of curvature of the convex curved tissue-contacting surface.
- the height suitably corresponds to the radius of the hemisphere.
- the height of the tissue-contacting members varies. That is, the plurality of tissue- contacting members include tissue-contacting members of different heights such that there is height variation within the population of tissue-contacting members.
- Suitable mean average height values are in the range 1 to 200 ⁇ , suitably 1 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 10 to 150 ⁇ , suitably 15 to 150 ⁇ , suitably 15 to 130 ⁇ , suitably 15 to 120 ⁇ , suitably 15 to 1 10 ⁇ , suitably 15 to 100 ⁇ , suitably 15 to 90 ⁇ , suitably 15 to 80 ⁇ , suitably 15 to 70 ⁇ , suitably 15 to 60 ⁇ , suitably 15 to 50 ⁇ , suitably 15 to 45 ⁇ , suitably 15 to 45 ⁇ , suitably 25 to 45 ⁇ , suitably 30 to 45 ⁇ , suitably 30 to 42 ⁇ , suitably 32 to 42 ⁇ , suitably 34 to 42 ⁇ , suitably 34 to 40 ⁇ , suitably 35 to 40 ⁇ , suitably 36 to 40 ⁇ , suitably about 38
- a suitable lower limit for mean average height is 1 ⁇ , suitably 5 ⁇ , suitably 10 ⁇ .
- the height is measured from the "base" surface located between the tissue-contacting members.
- the height corresponds to the radius of the hemisphere.
- At least 30% of the population of the tissue-contacting members fall within the height range of 1 to 200 ⁇ , suitably 1 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 15 to 130 ⁇ , suitably 15 to 120 ⁇ , suitably 15 to 1 10 ⁇ , suitably 15 to 100 ⁇ , suitably 15 to 90 ⁇ , suitably 15 to 80 ⁇ , suitably 15 to 70 ⁇ , suitably 15 to 60 ⁇ , suitably 15 to 50 ⁇ , suitably 15 to 45 ⁇ , suitably 20 to 45 ⁇ .
- a suitable lower limit for the height is 1 ⁇ , suitably 5 ⁇ , suitably 10 ⁇ .
- at least 40% of the population of the tissue-contacting members fall within this height range, suitably at least 50% of the population, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably at least 90%.
- a notional base surface/plane can be obtained with reference to height profile information (of the sort shown in figures 10-1 B and 10-2B, obtained from laser confocal imaging data), with the notional base surface/plane being plotted to coincide with the troughs/valleys between the peaks.
- the mean average height values are suitably selected from the ranges as set out above and the following ranges: suitably 1 to 200 ⁇ , suitably 1 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 5 to 130 ⁇ , suitably 5 to 120 ⁇ , suitably 5 to 1 10 ⁇ , suitably 5 to 100 ⁇ , suitably 5 to 90 ⁇ , suitably 5 to 80 ⁇ , suitably 5 to 70 ⁇ , suitably 5 to 60 ⁇ , suitably 5 to 50 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 40 ⁇ , suitably 5 to 35 ⁇ , suitably 5 to 32 ⁇ , suitably 5 to 30 ⁇ , suitably 5 to 28 ⁇ , suitably 5 to 25 ⁇ , suitably 10 to 40 ⁇ , suitably 10 to 35 ⁇ , suitably 10 to 30 ⁇ , suitably 15 to 40 ⁇ , suitably 15 to 35
- At least 30% of the population of the (non-spaced apart) tissue-contacting members fall within the height range of 1 to 200 ⁇ , suitably 1 to 150 ⁇ , suitably 5 to 150 ⁇ , suitably 5 to 130 ⁇ , suitably 5 to 120 ⁇ , suitably 5 to 1 10 ⁇ , suitably 5 to 100 ⁇ , suitably 5 to 90 ⁇ , suitably 5 to 80 ⁇ , suitably 5 to 70 ⁇ , suitably 5 to 60 ⁇ , suitably 5 to 50 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 45 ⁇ , suitably 5 to 40 ⁇ , suitably 5 to 35 ⁇ , suitably 5 to 32 ⁇ , suitably 5 to 30 ⁇ , suitably 5 to 28 ⁇ , suitably 5 to 25 ⁇ , suitably 10 to 40 ⁇ , suitably 10 to 35 ⁇ , suitably 10 to 30 ⁇ , suitably 15 to 40 ⁇ , suitably 15 to 35 ⁇ .
- a suitable lower limit for the height is 1 ⁇ , suitably 5 ⁇ , suitably 10 ⁇ .
- at least 40% of the population of the tissue-contacting members fall within this height range, suitably at least 50% of the population, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably at least 90%.
- the underlying surface of the implant material, on which the implant surface is overlaid, may be flat or not flat.
- the implant material may have a curved shape, e.g. to conform to the shape of the implant.
- the surface coverage of the tissue-contacting members being the extent to which the implant surface is covered by/provided by the tissue-contacting members, is at least 20% (% of total implant surface area covered).
- the surface coverage can be ascertained by taking measurements from suitable images of the surface, for example an SEM image.
- the surface coverage of the tissue-contacting members is at least 30%, suitably at least 40%, suitably at least 50%, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably at least 90%, suitably at least 95%, suitably at least 98%, suitably at least 99%, suitably about 100%.
- the number of tissue-contacting members, their size and placement, is such that the majority, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably substantially all, suitably all of the implant surface is provided by the convex curved tissue-contacting surfaces of the tissue-contacting members.
- This "high density" coverage is believed to be a particularly effective mimic of the adipose tissue surface.
- the implant surface has 100 to 100000 tissue-contacting members per cm 2 , suitably 100 to 50000, suitably 100 to 40000, suitably 200 to 40000, suitably 400 to 40000, suitably 500 to 40000, suitably 750 to 40000, suitably 900 to 35000, suitably 1000 to 35000, suitably 1200 to 35000, suitably 1500 to 35000, suitably 1750 to 32500, suitably 2000 to 30000, suitably 2250 to 30000, suitably 2250 to 27500, suitably 5000 to 40000, suitably 10000 to 40000, suitably 10000 to 30000, suitably about 25000 tissue-contacting members per cm 2 .
- a suitable lower limit for the density (tissue-contacting members per cm 2 ) of the tissue-contacting members is 100, suitably 500, suitably 5000, suitably 10000.
- a suitable upper limit for the density (tissue-contacting members per cm 2 ) of the tissue-contacting members is 100000, suitably 50000, suitably 40000.
- the plurality of tissue-contacting members are discrete members, in the sense that they are spaced from each other.
- the plurality of tissue-contacting members are not discrete members. Suitably they are adjacent each other, for example so as to appear to be merged or fused together.
- the plurality of tissue-contacting members is a plurality of truncated hemispheres arranged to form a two-dimensional array of fused hemispheres.
- tissue-contacting members are close packed.
- tissue-contacting members are arranged so as to have a packing structure corresponding to a layer in a close packed structure, especially selected from hexagonal close packed (hep) and face centred cubic (fee).
- each tissue-contacting member has at least four, suitably at least five, suitably six neighbours (i.e. other tissue-contacting members).
- each tissue-contacting member has at least four, suitably at least five, suitably six neighbours (i.e. other tissue-contacting members) within a distance corresponding to 2x the width (e.g. diameter) of the tissue-contacting member.
- a neighbour is deemed to be located within that distance if at least part of the neighbour is encompassed by an imaginary line defining a circle around the tissue-contacting member, which circle has a radius of, in the above case, 2x the width (e.g. diameter) of the tissue-contacting member.
- the distance corresponds to 1 .5x the width (e.g. diameter) of the tissue-contacting member.
- tissue-contacting members are substantially symmetrical about an axis of rotation that is perpendicular to the implant surface (the Z direction extending vertically from the implant surface).
- tissue-contacting members are substantially free from edge features and/or corner features.
- implant surface is substantially free from edge features and/or corner features.
- the implant surface has valleys formed by two or more adjacent tissue-contacting members (E.g. adjacent (part) hemispherical members). Indeed, the truncation of adjacent tissue-contacting members can provide the valleys.
- the valleys are interconnected. That is, one valley is joined to one or more other valleys (suitably such other valleys themselves being formed by adjacent tissue-contacting members). Valleys may be joined end- to-end to form the interconnected network.
- Two-dimensional array means that the tissue-contacting members are located in an array that extends in both linear directions parallel to the implant surface (X and Y directions).
- the array is a substantially hexagonal array.
- the two-dimensional array is a substantially regular two-dimensional array. This reflects the order in the adipose tissue surface, albeit that some deviation from true regularity exists. Nevertheless, even more regular/ordered arrays or irregular/disordered arrangements are possible.
- the mean average centre-to-centre nearest neighbour spacing of the array of tissue- contacting members, TCMCCAVE is from 1 to 200 ⁇ , suitably from 1 to 1 50 ⁇ , suitably from 1 to 120 ⁇ , suitably from 5 to 120 ⁇ , suitably from 1 0 to 120 ⁇ , suitably from 20 to 120 ⁇ , suitably from 30 to 120 ⁇ , suitably from 30 to 1 10 ⁇ , suitably from 30 to 1 00 ⁇ , suitably from 40 to 100 ⁇ , suitably from 40 to 90 ⁇ , suitably from 45 to 90 ⁇ , suitably from 50 to 90 ⁇ , suitably from 55 to 90 ⁇ , suitably from 60 to 90 ⁇ , suitably from 60 to 85 ⁇ , suitably from 65 to 85 ⁇ , suitably from 65 to 80 ⁇ , suitably from 68 to 80 ⁇ , suitably from 68 to 78 ⁇ , suitably from 69 to 75 ⁇ , suitably from 70 to 75 ⁇ , suitably about 73 ⁇ .
- centre point of a tissue- contacting member is the centre point when the implant surface is viewed "top-down".
- centre point is the centre of a circle whose circumference corresponds to the boundary of the tissue-contacting member in the X-Y plane (i.e. the relevant cross-section of the tissue-contacting member).
- the centre point can be obtained by selecting a circle whose diameter is such that the circle encompasses the X-Y cross section of the tissue-contacting member (i.e. when viewed "top-down").
- At least 30% of the population of the tissue-contacting members have a centre-to- centre nearest neighbour spacing in the range of from 1 to 200 ⁇ , suitably from 1 to 1 50 ⁇ , suitably from 1 to 120 ⁇ , suitably from 5 to 120 ⁇ , suitably from 10 to 120 ⁇ , suitably from 20 to 120 ⁇ , suitably from 30 to 120 ⁇ , suitably from 30 to 1 1 0 ⁇ , suitably from 30 to 1 00 ⁇ , suitably from 40 to 1 00 ⁇ , suitably from 40 to 90 ⁇ , suitably from 45 to 90 ⁇ , suitably from 50 to 90 ⁇ , suitably from 55 to 90 ⁇ , suitably from 60 to 90 ⁇ , suitably from 60 to 85 ⁇ , suitably from 65 to 85 ⁇ , suitably from 65 to 80 ⁇ .
- a suitable upper limit for mean average centre-to-centre nearest neighbour spacing is 200 ⁇ , suitably 150 ⁇ , suitably 100 suitably from 1 to 120 ⁇ .
- at least 40% of the population of the tissue-contacting members fall within this range, suitably at least 50% of the population, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably at least 90%.
- the mean average diameter of the plurality of tissue-contacting members, TCMdAVE is from 1 to 200 ⁇ , suitably from 1 to 1 50 ⁇ , suitably from 1 to 120 ⁇ , suitably from 5 to 120 ⁇ , suitably from 1 0 to 120 ⁇ , suitably from 20 to 120 ⁇ , suitably from 30 to 120 ⁇ , suitably from 30 to 1 10 ⁇ , suitably from 30 to 1 00 ⁇ , suitably from 40 to 1 00 ⁇ , suitably from 40 to 90 ⁇ , suitably from 45 to 90 ⁇ , suitably from 50 to 90 ⁇ , suitably from 55 to 90 ⁇ , suitably from 60 to 90 ⁇ , suitably from 60 to 85 ⁇ , suitably from 65 to 85 ⁇ , suitably from 65 to 80 ⁇ , suitably from 68 to 80 ⁇ , suitably from 68 to 78 ⁇ , suitably from 69 to 75 ⁇ , suitably from 70 to 75 ⁇ , suitably about 73 ⁇ .
- a suitable upper limit for mean average diameter is 200 ⁇ , suitably 150 ⁇ , suitably 100 ⁇ .
- the diameter of a tissue-contacting member can be obtained by following the methodology outlined above to obtain the centre point of the tissue-contacting member, whereby the circle selected in that method provides the diameter value for the tissue-contacting member.
- At least 30% of the population of the tissue-contacting members have a diameter in the range of from 1 to 200 ⁇ , suitably from 1 to 150 ⁇ , suitably from 1 to 120 ⁇ , suitably from 5 to 120 ⁇ , suitably from 10 to 120 ⁇ , suitably from 20 to 120 ⁇ , suitably from 30 to 120 ⁇ , suitably from 30 to 1 10 ⁇ , suitably from 30 to 100 ⁇ , suitably from 40 to 100 ⁇ , suitably from 40 to 90 ⁇ , suitably from 45 to 90 ⁇ , suitably from 50 to 90 ⁇ , suitably from 55 to 90 ⁇ , suitably from 60 to 90 ⁇ , suitably from 60 to 85 ⁇ , suitably from 65 to 85 ⁇ , suitably from 65 to 80 ⁇ .
- a suitable upper limit for mean average centre-to-centre nearest neighbour spacing is 200 ⁇ , suitably 150 ⁇ , suitably 100 ⁇ .
- at least 40% of the population of the tissue-contacting members fall within this range, suitably at least 50% of the population, suitably at least 60%, suitably at least 70%, suitably at least 80%, suitably at least 90%.
- the implant surface is a closed surface. That is, it is substantially free, suitably completely free, of pores or other open structures.
- the implant material is not an open cell or porous material. This does not preclude the bulk (i.e. underneath the surface) material having a porous or open structure.
- the implant surface may also comprise a nano-scale texture.
- a nano-scale texture For example this can be achieved by the use of oxygen plasma etching as discussed herein.
- the inventors have found that the provision of such nano-texture mimics the corresponding texture on the hemispherical surfaces of adipose cells.
- the tissue-contacting surfaces of the tissue-contacting members comprise nano-scale features (e.g. ridges or peaks) having a height (as measured e.g. by AFM) in the range from 200 to 800 nm, suitably 300 to 700 nm.
- the mean height of these features is in the range from 200 to 800 nm, suitably 300 to 700 nm, suitably 400 to 600 nm.
- the inventors envisage non-cosmetic use of the implant material. For example, in reconstructive surgery or breast augmentation, for example following oncologic surgery or injury.
- the implant material disclosed herein may be placed subcutaneously, subfascially or submuscularly.
- the implant may be located in the tissue plane between the adipose tissue of the breast (anteriorly) and the pectoralis muscle fascia (posteriorly).
- the implant material of the invention can be used in cosmetic methods, for example a cosmetic breast enlargement method. Such methods may comprise the step of implanting into the human body an implant comprising the implant material as disclosed herein.
- the implant material comprises, suitably comprises as a major component (e.g. at least 50wt% of the total weight of the implant material, preferably at least 60wt%, more preferably at least 70 wt%, more preferably at least 80wt%, more preferably at least 90wt%) in embodiments consist substantially of, in typical embodiments consist of, a suitable biocompatible material.
- a suitable biocompatible material e.g. the material is capable of being shaped, e.g. by casting etching and / or moulding into a textured surface.
- the material may comprise suitably comprises as a major component (e.g.
- At least 50wt% of the total weight of the implant material in embodiments consist substantially of, typically consist of, a biocompatible synthetic polymer, suitably an organo-silicon polymer, preferably a silicone, and more preferably polydimethylsiloxane (PDMS).
- a biocompatible synthetic polymer suitably an organo-silicon polymer, preferably a silicone, and more preferably polydimethylsiloxane (PDMS).
- the surface of the implant material for which surface roughness parameters are specified herein comprises the above-mentioned biocompatible synthetic polymer.
- the surface consists substantially of an organo-silicon polymer, preferably PDMA.
- the surface is a textured organo-silicon surface, the texture being as described herein.
- composition of the implant material is substantially homogeneous, especially in a depth direction from the surface (tissue-engaging surface) into the bulk material.
- the implant material suitably forms at least part of the surface layer of the relevant implant.
- surfaces of implants of the invention may partly comprise conventional implant surfaces as well as the novel and advantageous surfaces described herein.
- the implant material surfaces of the invention described herein forms at least half, in suitable embodiments more than half, preferably substantially all (e.g. at least 90%, 95%, 98% or 99% by area of the implant surface) of the tissue contacting surface of the implant, such as wherein the tissue contacting surface of the implant consists of said implant material.
- the material comprising the surfaces of the invention may be different to other materials in the implant or may be the same.
- the implant may comprise an underlayer layer of the same of different material to the implant surface layer of the invention.
- the implant may be any suitable implant capable of insertion into a patient, preferably a prosthetic implant, optionally an implant for internal insertion beneath the skin surface of a patient, more preferably a breast implant.
- the implant materials of the present invention are preferably configured so as to be inserted subcutaneously within a patient or may be administered externally.
- the implant is administered (is intended to be located) internally, e.g. subcutaneously, subfascially or submuscularly.
- a template for use in preparing an implant material comprises a textured surface as described according to any aspect or embodiment herein, or a negative (e.g. an inverse cast) of a textured surface as described herein.
- the template may typically comprise the 3-dimensional information, i.e. ⁇ , ⁇ , ⁇ information, corresponding to the implant material surface of the invention as defined according to any aspect and embodiment herein.
- the template is a stamp or mould, e.g. a stamp for imprinting a surface texture of the invention onto an implant surface or moulding the implant surface, optionally wherein the stamp or mould is a silicone stamp or mould.
- a surface may be stamped or moulded a number of times to provide an implant material having a surface as defined above.
- the template itself is a mould.
- the use of moulds is beneficial as they can be used to manufacture a large number of implants quickly.
- a method of preparing an implant material having a textured surface comprising the steps of acquiring spatial data in the X, Y and Z dimensions (i.e. three-dimensional spatial data) from an adipose tissue surface and using said spatial data to create the textured surface of the implant.
- the use of the spatial data further comprises the step of processing the spatial data and using the processed data to create the textured surface of the implant.
- the inventors thus propose the acquisition of 3D image / topography data corresponding to an adipose tissue surface for reproduction on (formation of) an implant surface.
- This approach represents a considerable departure from conventional approaches to texturising implant surfaces, which are largely based on trial and error application of crude and often irreproducible methods which do not provide suitable control of the implant surfaces produced (e.g. by making open cell foam or by texturising using salt methods).
- the step of acquiring the spatial ⁇ , ⁇ , ⁇ data is performed by any suitable contact or non-contact profilometer, suitably by atomic force microscopy, 3D laser scanner or optical profiler.
- the step of creating the textured surface using the spatial ⁇ , ⁇ , ⁇ data includes three dimensional printing or photolithography or E-beam lithography, particularly optical photolithography, e.g. UV lithography, e.g. using a laser writer.
- the method includes the step of processing the 3D data (spatial ⁇ , ⁇ , ⁇ ) by converting, suitably digitally converting the respective data to a form of data that can be read by a maskless lithography system.
- the processing step includes formation of a two or more 8 bit (or optionally 16 bit) grayscale image wherein the 256 (e.g. or optionally 65536) different grayscale intensities corresponds to changes in vertical height of a measured surface.
- the processing step includes joining two or more grayscale images (maps) to form a mosaic montage of surface images prior to applying the image to a surface, for example prior to assigning a number of radiation doses on every pixel and thus controlling the exposure of the photoresist.
- grayscale images maps
- E-beam Lithography may allow the reproduction of features that are ⁇ 50nm in lateral resolution.
- the process of forming the surface of the invention from using the spatial ⁇ , ⁇ , ⁇ data includes using Electron Beam (E-beam) Lithography.
- the method further comprises using the spatial ⁇ , ⁇ , ⁇ data to expose a photoresist (for example an E-beam photoresist) comprising the respective ⁇ , ⁇ , ⁇ information.
- the method suitably includes use of the exposed and developed photoresist (for example an E-beam resist) to form the textured surface.
- the step of using the exposed and developed photoresist to transfer the textured surface onto a template may optionally comprise using an etching method, optionally oxygen etching and/or deep reactive ion etching.
- Embodiments of the method include use of the spatial ⁇ , ⁇ , ⁇ data to expose the photoresist and/or an e-beam resist comprising using the spatial ⁇ , ⁇ , ⁇ data to instruct the delivery of varying doses of radiation to a photoresist and/or E-beam resist surface so as to expose a photoresist and/or E-beam resist comprising the respective ⁇ , ⁇ , ⁇ information.
- photolithography methods for preparing 3D features in objects use a graded photomask to control the relative intensity of radiation received by various parts of the photoresist during the photolithography step.
- the lithography method is a maskless lithography method.
- the step of preparing the photoresist includes increasing or decreasing the scale of the original X, Y and /or Z parameters for reproduction in the photoresist. This may be used advantageously if the photoresist needs to be thinner in the vertical direction that the vertical features of the surface being reproduced. The features may this be scaled up again during another step, such as using etching, e.g. deep reactive ion etching.
- a method of preparing an implant material having a textured surface comprising the step of making a cast of an adipose tissue surface, the cast containing spatial data representing the X,Y and Z dimensions and using said cast to make the textured implant material.
- the method comprises the step of preparing said textured implant material surface by etching, stamping or moulding. In embodiments, the method comprises the step of preparing said textured implant material surface by etching. In embodiments the method comprises the step of preparing said textured implant material surface by stamping, optionally multiple stamping of a single surface to produce a textured surface having a number of stamped irregular textured regions, e.g. wherein the stamped images cover at least half, suitably more than half, and in embodiments substantially all of the implant surface configured to contact a patient's tissue when inserted. In embodiments the method comprises the step of preparing said textured implant material surface by moulding.
- the implant material prepared by said method is an implant material as described in any one of the aspects and embodiments of the invention described herein.
- the textured material is a textured implant material as described herein or a template as described herein.
- a method of processing and / or modifying spatial data in the X, Y and Z dimensions suitably so as to provide a data set capable of being used by a printer, for example a laser writer or 3D printer.
- the use includes wherein the spatial data acquired from the adipose tissue surface is processed before use in said method of preparation.
- a data carrier suitably a computer readable data carrier, comprising spatial data as defined herein.
- the tissue i.e. the tissue from which spatial data is the X, Y and Z dimensions has been obtained or is representative of
- adipose tissue preferably adipose tissue of the breast.
- an implant material comprising a textured surface as prepared by a method as defined according to any aspect or embodiment herein.
- a template for use in preparing an implant material of the invention as described herein said template having textured surface parameters as defined herein, or a negative of said textured surface parameters, optionally wherein the template is a mould or stamp, such as defined above.
- the invention also provides the use of a template as described herein in a method of making a textured implant material.
- the template is a silicone template, most preferably PDMS.
- a cosmetic method comprising the step of inserting an implant material as described in any of the aspects and embodiments of the invention disclosed herein subcutaneously in a patient.
- said method is so as to provide minimal or no capsular contraction and / or cellular immunogenic response.
- the method is for reconstructions of the breast.
- composition which is “substantially free” from Y may be completely free from Y. Where necessary, the word “substantially” may be omitted from the definition of the invention.
- the term “irregular” in the context of the surfaces of the present invention refers to surface areas which are devoid of regular geometric patterns (such as repeating patterns), such as at the relevant macro, micro and / or nano scales (such as at the 1 cm x 1 cm, 1 mm x 1 mm, 100 micron x 100 micron and / or at sub-micron level).
- regular geometric patterns such as repeating patterns
- nano scales such as at the 1 cm x 1 cm, 1 mm x 1 mm, 100 micron x 100 micron and / or at sub-micron level.
- the term “irregular” in the context of the surfaces of the present invention thus includes surfaces which appear to be disordered.
- the surface of implants prepared according to the present invention may be formed by use of a stamp having an irregular textured surface which imparts its irregular surface topography to the implant on stamping.
- the stamp may thus be used repeatedly over the surface of the implant to ultimately provide up to complete surface coverage consisting of the substantially repeated irregular surface imprinted by the stamp.
- the term "irregular" within the meaning of the present invention includes surfaces which have more than one, such as a plurality of repeating areas of such irregular surface topography.
- Figure 1 shows a flow diagram of the manufacture process of the implant surfaces.
- Figure 2 shows S.E.M. image of surface of breast locule illustrating the close-packed spherical nature of this surface. Scale bar 100 ⁇ .
- Figure 3 is a laser confocal Height Map of Native breast tissue.
- Figure 4 shows laser confocal output capturing the "Adipose Original Surface ".
- Figure 5 is a schematic of "Nearest neighbour” distance and "Diameter”.
- Figure 6A is a histogram of Sphere diameter.
- Figure 6B is a histogram of Nearest Neighbour Distances.
- Figure 7 shows Matlab defined image.
- Figures 8A, 8B and 8C show statistical information obtained from the model surface.
- Figure 9 shows the etched Modelled Surface.
- Figure 9B shows graph indicating nano-texture height correlation with etch recipe.
- Figure 10 shows information on the native tissue and on the Modelled Surface when transferred into Silicone: 1A bitmap image height data generated from Matlab programme; 1 B height profile of bitmap 1 A along the black line in 1 A; 1 C, a 3D representation of the bitmap in 1A; 2A a 2D scan of the actual silicone surface created using SU8 and scanned with a laser confocal microscope; 2B height profile of 2A along the black line in this figure; and 2C a 3D representation of the actual modelled surface Actual Laser confocal scanned surface.
- Figures 1 1A and 1 1 B show an S.E.M. image of Fibroblasts adhered to Adipose surface and S.E.M. image of THP-1 Macrophages attached to Adipose Surface.
- Figures 12A and 12B show an S.E.M. image of Fibroblasts adhered to Modelled surface and S.E.M. image of THP-1 Macrophages attached to Modelled Surface.
- Figure 14 shows QRT-PCR Relative gene expressions of IL-10, TNF-Alpha, ILB1 , CD206 and IL6 compared to Tissue Culture Plastic.
- Figure 15 shows Relative cytokine production of GRO-Alpha, IL10, IL8 and TNF Alpha in comparison to Tissue Culture Plastic.
- Adipose tissue was washed four times in distilled water for 15 minutes each and then post fixed in osmium tetroxide 1 % (Agar Scientific, UK) in 0.1 M hepes (Formedium) for 1 hour. Following two further wash steps in distilled water of 15 minutes each, the tissue was dehydrated using graded acetone steps of 25%, 50%, 75%, 90%, and 100%, for 15 minutes at each step. Three further washes in 100% acetone were then performed before the tissue was critical point dried (Quorum Technologies Ltd. East London, England).
- the Original Adipose surface was further analysed to define its statistical characteristics.
- Matlab code was engineered to recognise boundaries between each hemisphere within these images. This was achieved through watershed segmentation (see figure 6C). The maximal height of each of these segments was then established by the code to recognise the centroid position of each hemisphere within these segments, before a 3D sphere fit function established the closest fit of a sphere to each segment. Code also generated data for the nearest neighbour distance (the distance between one centroid and the next) and hemisphere diameter. ( Figure 5) MATLAB CODE DEFINES AN "MODELLED ADIPOSE" SURFACE
- the Matlab code produced a surface, generated from the measurements taken from the "original adipose” surface. By combining the hemisphere diameter and relation of each hemi- sphere to its nearest neighbour a new “Modelled Adipose” surface was generated with the same statistical attributes as the native tissue. (Figure 6C). This allowed the generation of a new "modelled adipose” bitmap image (figure 7). The "modelled adipose" surface had the same statistical attributes as that of the original adipose surface. The statistical data is shown with the lognormal distribution fits in figures 8A, 8B and 8C.
- a 4 x 4 cm plain silicon wafer was sonicated for 10 minutes in acetone, isopropyl alcohol (I PA) and distilled water, dried with nitrogen gas and baked on a hot plate for 10 minutes at 150°C. Hexamethyldisilazane (Microchem, USA) was then spun onto the wafer at 3000rpm for 45 seconds before it was returned to the hotplate for a further 10 minutes. As an adhesion layer, SU8-2000.5 (Microchem, USA) was spun onto the wafer at 3000rpm and ramp baked from 25°C to 95°C before being held at 95°C for 5 minutes.
- the SU- 8 coated wafer was flood exposed to 454nm wavelength light for 20 seconds before being returned to the hotplate for a further 5 minutes.
- the SU-8 coated wafer was developed in EC solvent for 1 minute before being rinsed in I PA and baked at 150°C for 10 minutes.
- a secondary, thicker layer, of SU-8 2025 (Microchem, USA) was then spun onto the surface of the base layer coated wafer at 4000rpm, corresponding to a thickness of 30 ⁇ " ⁇ . This was followed by a ramped pre-exposure bake from 25°C to 95°C before being held at 95°C for 10 minutes.
- the wafer was exposed to either the "original adipose” or “modelled adipose” pattern using a laser writer (LW405 Microchem, Italy).
- Bitmap images were inverted prior to use using imageJ(19).
- Inverted bitmap images were loaded into the laserwriter software and pixel size was registered to 0.5 ⁇ in X and Y.
- a 40x objective was used to expose the photoresist and laser power dose was dictated by the corresponding grayscale level (0 being no dose and 256 being maximum dose).
- Optimisation was performed on a grayscale wedge design and bitmap images were re-formatted using a code in Matlab to improve the linearity of the photoresist.
- the wafer was subject to a post exposure bake for 10 minutes at 95°C before development of the pattern in Mlcroposit EC solvent (Chestech Ltd, UK) for 10 minutes with gentle agitation. Substrates were then rinsed in IPA.
- TMCS trimethylchlorosilane
- Fabricated implant surfaces were characterised using AFM, laser confocal imaging and Scanning Electron microscopy.
- Human THP-1 monocyte cells were cultured in RPMI 1640 medium, "normal media” (Sigma Aldrich, UK) supplemented with 1 % penicillin and streptomycin (PAA), 1 % L-glutamine (PAA) and 10% Fetal Bovine Serum (PAA) in T75 tissue culture plastic (TCP) flasks (Corning Incorporated, USA). Monocytes were incubated at 37°C in 5% CO2 and media was changed weekly. THP-1 monocytes were treated with 25nM phorbol myristate acetate (PMA, Sigma Aldrich, UK) for 24 hours to facilitate differentiation into macrophages.
- PMA phorbol myristate acetate
- macrophages were washed twice with normal media and rested for a further 24 hrs in normal media. Prior to seeding, macrophages were serum starved for 24hrs in 0.5% FBS media to synchronise these cells. Cells were seeded at 250,000 cells per well of a 24 well culture plate (Corning Incorporated, USA) and each experiment was performed in triplicate.
- Manufactured surfaces were cut into 15mm disks using a punch cutter, before being adhered to the bottom of a 24 well plate (Corning Incorporated) using a drop of uncured MED 6215 silicone, which was cured overnight at 65°C. TCP and a smooth MED6215 silicone surface, manufactured by curing PDMS on a plain silicon wafer were used as controls. Prior to cell seeding manufactured surfaces were washed twice with PBS and sterilised using 70% ethanol for 15 minutes. Manufactured implants were air dried for half an hour and washed twice with PBS. For Confocal microscopy, 6mm biopsies were taken of the manufactured surfaces and
- TNF alpha Tumour Necrosis Factor Alpha
- ILB1 Interleukin Betal
- IL6 Interleukin 6
- IL10 Interleukin 10
- CD206 Mannose Receptor
- Luminex analysis was performed by ProcartPlexTM Mulitplex Immunoassay (eBioscience, Vienna, Austria) for human IL-1 RA, IL-1 beta, IL-6, IL-8, IL-10, IL- 12, TNF alpha, IFN gamma and GRO alpha as per manufactures instructions.
- Immunocytochemistry was performed on breast derived fibroblasts for vinculin, F-Actin and DAPI. Immunocytochemistry was performed on macrophages using Integrin a-v. Disks of the manufactured implant surfaces were cut with a 6mm punch biopsy, adhered to 8mm circular cover-slips using 3 ⁇ of mixed MED-6215 silicone and cured at 65°C overnight, sterilising and seeding with 10,000 macrophages or 5,000 fibroblasts.
- fibroblasts were incubated in Anti-Vinculin antibody at a dilution of 1 :200 in 10% BSA (V9131 , Sigma-Aldrich, UK) for 1 hr at room temperature (RT). After washing macrophages were incubated in Anti-lntegrin a-v at a dilution of 1 :750 in 10% BSA (ab124968, Abeam, Cambridge, UK) for 1 hr at RT.
- TBS-Tween TBS-Tween
- TBS-Tween 0.1 % Tween in TBS
- Alexa-Fluor-488 dye Invitrogen, UK
- Adipose surface remains intact after tissue fixation
- Laser confocal microscopy defines adipose locule texture statistics
- Laser confocal data allows extraction of statistical data from the adipose surface
- Matlab code written to extract the statistical data of the surface allowed measurement of nearest neighbour distances and sphere diameters (figure 5).
- Sphere diameters ranged from 16.8 ⁇ to 152.53 ⁇ (mean 43.26 ⁇ , median 40.6 ⁇ , S.D. 13.69 ⁇ ) (Figure 6A), whilst nearest neighbour distances ranged from 30.69 ⁇ to 159.09 ⁇ (mean 71 .4 ⁇ , median 66.8 ⁇ , S.D. 31.77 ⁇ ) ( Figure 6B).
- Matlab Code defines the Base structure of the "Adipose Surface"
- Matlab code Based upon the recognised spheres on the surface of a sample, Matlab code generated the base texture of the new grayscale Modelled Adipose surface based upon the position and sphere diameters on this surface (figure 6C, 7).
- AFM statistically quantifies the adipose surface
- Height profiles of 12 adipocytes from data were obtained from the AFM scans of the adipocyte surfaces. Height profiles varied between each adipocyte, but the information gained allowed a an etch recipe to be determined to mimic the height profiles/texture on the modelled adipose surface.
- AFM scans of this nano-texture showed it has a random roughness on its surface and a height profile which matches that of the adipocytes.
- the surface of the SU-8 mould was textured using a 6.5 minute oxygen etch recipe which produced a texture on the surface of the mould (figure 12B, etched for 6.5mins) with statistics and a surface height which lay within the range of that measured in native breast adipocytes.
- Figure 10-1 A illustrates the height data generated by the Matlab code for the surface of the modelled adipose surface in 2d, as a 3D representation (10-1 C) and as a graph of the profile of this surface (10-1 B) along the black line in image 10-1A.
- Figure 10 2A, 2B, 2C shows the adipose modelled surface scanned using a laser confocal microscope and the same 2D, 3D and profile results.
- Fibroblasts and macrophages were grown in culture on the surface of the Original Adipose and Modelled Adipose Surfaces. Fibroblasts adhered to these surfaces and conformed to the macro texture beneath them, orientating along the valleys of the spherical features beneath them as shown most apparently in figure 1 1 A, 12A.
- Macrophages were also clustered around the circumference of the spherical features in figure 1 1 B, 12B.
- Modelled Adipose Surface induces a positive alteration in gene profiles cultured on its surface when compared to smooth silicone surfaces
- Modelled Adipose Surface induces a positive alteration in cytokine expression in macrophages cultured on its surface
- the novel surface texture has been shown to reduce the inflammatory response of macrophages and induce an alternatively activated macrophage phenotype in the initial biomaterial in-vitro response.
- the inventors Via careful surface analysis and subsequent modelling, the inventors have characterised the relevant features of native breast adipose tissue. Specifically, this has led to a better understanding of the shapes and arrangement of features on the surface of native breast tissue and this in turn has assisted replication of these features in silicone.
- a complex overlaid micro- and nano-texture has been achieved in the surface of medical grade silicone, which mimics that found within the breast.
- a challenging macrophage-based assay To examine the in-vitro effect of implant texture a challenging macrophage-based assay has been used, being a cell type with an undisputed role in the regulation of the foreign body reaction.
- Macrophages arrive at the biomaterial wound interface within the first few hours and remain for several days and dictate the downstream foreign body reaction, which is why 12 and 24 hr time points have been chosen to assess their reactions.
- Pro-inflammatory cytokines ⁇ _-1 ⁇ ,(27), IL-6(28), TNF alpha(29) and IL-8(30) involved in macrophage activation and IL-10(31 ) a potent anti-inflammatory cytokine all have important roles in the reaction of macrophages to biomaterial surfaces and in dictating the remainder of the foreign body reaction.
- IL8 and TNF-Alpha have also been found to be upregulated in contracted fibrotic capsules.
- Each of the genes associated with these cytokines or the cytokines themselves were favourably modulated by the novel implant surface.
- Fibroblasts are the traditional cell type used to assess the reaction to implant surfaces as they generate extra cellular matrix which is the main component of the capsule. Fibroblasts were included in the assessment of the implant surfaces as an indicator of cell alignment because this, with the smooth surface implants, has been theorised to increase contracture rates. (17) Fibroblasts are recruited from approximately 24-48 hours after the wound is created at the end of the inflammatory phase and at the beginning of the proliferative phase and are activated by the chemoattractants and cytokines produced by macrophages. (33) The implant surface has shown that the fibroblasts recognise the surface of the implant and track along the valleys between each hemisphere on the surface in a range of different directions, thus breaking the alignment seen in the smooth surface implants.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Epidemiology (AREA)
- Medicinal Chemistry (AREA)
- Dermatology (AREA)
- Chemical & Material Sciences (AREA)
- General Physics & Mathematics (AREA)
- Physics & Mathematics (AREA)
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- Materials For Medical Uses (AREA)
Abstract
Description
Claims
Priority Applications (12)
Application Number | Priority Date | Filing Date | Title |
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US15/780,993 US11202698B2 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
EP20202612.6A EP3788986A1 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
EP16805160.5A EP3383314B1 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
IL259774A IL259774B2 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
CA3007138A CA3007138A1 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
DK16805160.5T DK3383314T3 (en) | 2015-12-04 | 2016-12-02 | TEXTURED SURFACES FOR IMPLANTS |
IL296868A IL296868A (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
BR112018011317-4A BR112018011317B1 (en) | 2015-12-04 | 2016-12-02 | IMPLANT MATERIAL, TEMPLATE FOR USE IN PREPARING IMPLANT MATERIAL AND METHOD FOR PREPARING IMPLANT MATERIAL |
KR1020187019100A KR20180103873A (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
CN201680080757.3A CN109069251B (en) | 2015-12-04 | 2016-12-02 | Textured surface of implant |
ES16805160T ES2857498T3 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
US17/525,022 US20220142762A1 (en) | 2015-12-04 | 2021-11-12 | Textured surfaces for implants |
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GBGB1521474.5A GB201521474D0 (en) | 2015-12-04 | 2015-12-04 | Textured surfaces for implants |
GB1521474.5 | 2015-12-04 |
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US15/780,993 A-371-Of-International US11202698B2 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
US17/525,022 Continuation US20220142762A1 (en) | 2015-12-04 | 2021-11-12 | Textured surfaces for implants |
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WO2017093528A1 true WO2017093528A1 (en) | 2017-06-08 |
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PCT/EP2016/079659 WO2017093528A1 (en) | 2015-12-04 | 2016-12-02 | Textured surfaces for implants |
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US (2) | US11202698B2 (en) |
EP (2) | EP3788986A1 (en) |
KR (1) | KR20180103873A (en) |
CN (2) | CN113520668A (en) |
BR (1) | BR112018011317B1 (en) |
CA (1) | CA3007138A1 (en) |
DK (1) | DK3383314T3 (en) |
ES (1) | ES2857498T3 (en) |
GB (1) | GB201521474D0 (en) |
IL (2) | IL259774B2 (en) |
PT (1) | PT3383314T (en) |
WO (1) | WO2017093528A1 (en) |
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US10864661B2 (en) | 2012-12-13 | 2020-12-15 | Allergan, Inc. | Device and method for making a variable surface breast implant |
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- 2016-12-02 IL IL259774A patent/IL259774B2/en unknown
- 2016-12-02 CA CA3007138A patent/CA3007138A1/en active Pending
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Also Published As
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EP3383314A1 (en) | 2018-10-10 |
US11202698B2 (en) | 2021-12-21 |
IL259774A (en) | 2018-07-31 |
CN109069251A (en) | 2018-12-21 |
DK3383314T3 (en) | 2021-02-22 |
ES2857498T3 (en) | 2021-09-29 |
EP3788986A1 (en) | 2021-03-10 |
IL259774B2 (en) | 2023-03-01 |
US20220142762A1 (en) | 2022-05-12 |
PT3383314T (en) | 2021-03-03 |
BR112018011317A2 (en) | 2018-12-04 |
EP3383314B1 (en) | 2020-11-25 |
IL259774B (en) | 2022-11-01 |
GB201521474D0 (en) | 2016-01-20 |
KR20180103873A (en) | 2018-09-19 |
IL296868A (en) | 2022-11-01 |
CA3007138A1 (en) | 2017-06-08 |
BR112018011317B1 (en) | 2023-03-14 |
CN109069251B (en) | 2021-07-09 |
CN113520668A (en) | 2021-10-22 |
US20200268499A1 (en) | 2020-08-27 |
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