JP2007533405A - 外科手術用のメッシュ状インプラント - Google Patents
外科手術用のメッシュ状インプラント Download PDFInfo
- Publication number
- JP2007533405A JP2007533405A JP2007509511A JP2007509511A JP2007533405A JP 2007533405 A JP2007533405 A JP 2007533405A JP 2007509511 A JP2007509511 A JP 2007509511A JP 2007509511 A JP2007509511 A JP 2007509511A JP 2007533405 A JP2007533405 A JP 2007533405A
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- JP
- Japan
- Prior art keywords
- surgical prosthesis
- biodegradable
- layer
- yarn
- carbodiimide
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
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- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
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Abstract
Description
カルボジイミドとの反応で変性したポリアニオン性多糖類は、カルボジイミド変性ヒアルロン酸と、カルボジイミド変性カルボキシメチルセルロースとを含む。
リウムを含む。促進剤は、N−ビニルカプロラクタムを含む。ある実施形態の場合には、液剤は、1重量%のカルボジイミド変性ヒアルロン酸およびカルボジイミド変性カルボキシメチルセルロースと、アクリレート・エステルで末端がキャップされた2.5重量%のポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーと、40ppmのエオシンYと、4000ppmのN−ビニルカプロラクタムと、0.54重量%のトリエタノールアミンと、0.8重量%のリン酸カリウムとを含む。
図1A〜図1Cを参照すると、腹部内の開口部のような体腔内の望ましくない開口部を治療するための外科用プロテーゼ10は、三次元メッシュ30により支持されている癒着バリア20を含む。図1A〜図1Cの場合には癒着バリア20を含んでいるが、図2A〜図2Cの場合には癒着バリア20を含んでいない三次元メッシュ30は、少なくとも2つの層(この場合は2つである)を形成する生分解性糸32および非生分解性糸34から形成される。特に図1Bを参照すると、少なくとも2つの層のうちの一方、層33は、第1のメッシュ表面35を形成していて、実質的に非生分解性である。特に図1Cを参照すると、少なくとも2つの層のうちの他方、層37は、第2のメッシュ表面39を形成していて、実質的に生分解性である。層33および37は、生分解性結合糸40により相互に接続している。外科用プロテーゼ上で癒着が起こるのを実質的に防止する癒着バリア20は、生分解性層37上に直接形成され(例えば、重合され)、それにより癒着バリア20とメッシュ30とを相互に接続する。
メッシュ30は、生分解性糸32および非生分解性糸34を含む、任意の織ったまたは編んだ構造である。通常、メッシュ内の生分解性糸に対する非生分解性糸の比率は約0.1〜9である。ある実施形態の場合には、生分解性糸に対する非生分解性糸の比率は1〜2.33である。メッシュ30は、一方の側面上には、癒着バリア20が生分解性層37内で絡み合い結合することができる構造を有し、他方の側面上には、細胞の内部への生長および治療のための強力な支持フレームを供給する構造を有する。例えば、図2A〜図2Cの実施形態のようなある実施形態の場合には、メッシュ30は、層33および37を形成するために相互に絡み合い、および/または相互にルーピングしている生分解性糸および非生分解性糸を含む。例えば、図3A〜図3Bの実施形態のようなある実施形態の場合
には、メッシュ30は、非生分解性糸34からできている予め形成済みの非生分解性メッシュ33、および生分解性結合糸40と一緒に縫い合わされている生分解性糸32からできている予め形成済みの生分解性メッシュ37を含む。
癒着バリア20組成物は、生分解性材料からなるゲル、フォーム、フィルムまたは膜を含むことができる。癒着バリア20は、ヒアルロン酸および任意のその塩、カルボキシメチルセルロースおよび任意のその塩、酸化再生セルロース、コラーゲン、ゼラチン、リン脂質、および以下に説明する第1および第2の高分子系、およびその任意の架橋または誘導形から選択した1つまたは複数の成分から作ることができる。ある実施形態の場合には、バリアは、塩水、リン酸緩衝液、または体液のような水性流体と接触するとヒドロゲルを形成することができる材料から作られる。
ロックと、生分解性ブロックと、架橋ブロックとを含む。マクロマーは、少なくとも1つの親水性ブロックと、少なくとも1つの生分解性ブロックと、少なくとも1つの重合性基とを含む大きな分子である。これらのブロックのうちの1つまたは複数の性質は重合性のものであってもよい。生分解性ブロックのうちの少なくとも1つは、炭酸塩またはエステル基をベースとする結合を含み、マクロマーは、炭酸塩またはエステル基の他に他の分解性結合または基を含有することができる。米国特許第6,083,524号および米国特許第5,410,016号に、高分子ヒドロゲルを形成する適当なマクロマーおよびその製造方法が記載されている。これらの米国特許の内容は参照により本明細書に組み込むものとする。
ン酸、またはシトラコン酸またはそのエステルまたはアミド等がある。不飽和トリカルボキシル酸としては、アコニン酸またはそのエステルまたはアミド等がある。また、重合性基は、アクリルアミド、N−イソプロピルアクリルアミド、ヒドロキシエチルアクリレート、ヒドロキシエチルメタアクリレート、および類似のビニルおよびアリル化合物のようなこのような材料の誘導体であってもよい。
この場合、ポリエチレン・グリコール反復単位は、−(CH2−CH2−O)x−または(PEG)xであり、炭酸トリメチレン反復単位は、−(C(O)−O−(CH2)3−O)w−または(TMC)wであり、乳酸残基は、−(O−CH(CH3)−CO)y−または(L)yであり、アクリレート残基は、CH2=CH−CO−またはAであり、q、w、w'、y、y'およびxは整数である。
A−(L)y−[(PEG)x−(TMC)w']q−(L)y'−A
A−[(PEG)x−(TMC)w']q−(L)y'−A]
マクロマーの重合は、光化学的手段、非光化学的類似レドックス(Fenton化学)、または熱的開始(過酸化物等)によりスタートすることができる。適当な光化学的手段は、好適には、エオシンYであることが好ましい、染料のような紫外線または光感光化合物のような光重合開始剤の存在下での可視光線または紫外線によるマクロマー溶液の照射等がある。
メチレン残基(マクロマー毎に7以上、平均約12の残基)およびグリコール・コアの両方の端部に順次延び、また両方の端部間にランダムに分布し、2つのアクリレート基で終わっている乳酸残基(マクロマー毎に5以下の残基)を有する20×103Daポリエチレン・グリコール・コアを有するマクロマーである。
バリア組成物を調製する目的で、第2の高分子系のマクロマー溶液と混合する前に、流体ゲルを形成するために、変性したポリアニオン性多糖類組成物を、緩衝溶液内だけで再度水和することができる。また、バリア組成物は、第2の高分子系のマクロマー溶液の緩衝溶液内で、変性したポリアニオン性多糖類組成物を再度水和し、それにより両方の高分子系を含む流体ゲルを形成することにより調製することができる。次に、流体ゲルを所望の形の皿に入れ、本発明のバリア組成物を形成するために、紫外線または可視光線のような重合条件で処理が行われる。流体ゲル内のマクロマーが重合すると、バリア組成物は、改善された処理特性を有し、裂けにくい水和された柔軟でゴム状の物質を形成する。バリア組成物は、適当な鋳型を選択することによりまたは押し出すことにより、シート、ディスク、チューブまたはロッドのような所望の形の物品に重合することができる。
を含む溶液から形成される実施形態の場合には、バリア組成物を流体ゲル内で織物を入れて、重合をスタートさせることにより織物の上に堆積することができる。疎水性の織物は流体ゲルの表面上に浮く。極性基を有する織物のような疎水性がもっと低い織物(例えば、エステル、アミド、ケトン、および炭酸塩)は、織物の存在下でマクロマー上の官能基の重合によりバリア組成物が織物にもっと密着するように、流体ゲル内に表面を通してある程度貫通することができる。ある層が他の層より疎水性が低い本発明の合成多重層織物の場合には、織物の疎水性の低い面を流体ゲル上に置くと、織物のその面上の繊維は流体ゲルを貫通し、一方、織物の他の面上の疎水性繊維は流体ゲル上に浮く。組成物が重合すると、高分子網目の一部は、織物の疎水性の低い繊維を捕捉し、織物上のバリアの接着強度が増大する。
通常、癒着バリアは、フィルム、フォーム、またはゲルの形をとることができる。ある実施形態の場合には、癒着バリアは、1平方フィート当たり全ポリマーの約20グラム以下の密度を有する。ある実施形態の場合には、癒着バリアは、1平方フィート当たり全ポリマーの約4〜約6グラムの密度を有する。ある実施形態の場合には、癒着バリアは、1平方フィート当たり全ポリマーの約5グラムの密度を有する。
編むことにより形成される。この場合、非生分解性糸および第1の生分解性糸は、層33および層37をそれぞれ形成し、また第2の生分解性糸は層33および37を一緒に結合する。メッシュ30に癒着バリア20を塗布するために、光開始剤および癒着バリア前駆体成分を含む液剤がガラスのトレイに追加される。次に、メッシュ30は、トレイ内に入れられるが、その場合、生分解性面(層37)はトレイの底面を向いている(例えば、生分解性層は液剤と流体接触している)。光開始剤(例えば、約450nm〜約550nmの波長を有し、約1mW/cm2〜約100mW/cm2の輝度を有する光源)を作動する光源でトレイを照射することにより液剤が光重合する。光開始の結果、トレイ内の層37の少なくとも一部の周囲にヒドロゲルが形成される。次に、結果として得られるメッシュ/ヒドロゲルが、約2%以下(例えば、約0.8%のような、約1.2%以下の)の含水率になるようにヒドロゲルの乾燥が行われる。次に、メッシュ/乾燥したヒドロゲルは殺菌されて外科用プロテーゼ10になる。
(実施例1)
三次元メッシュを作るために、2つの5ミルのポリプロピレン・モノフィラメント繊維(サウスカロライナ州コロンビア所在のShakespeare Monofilament and Specialty Polymers社)、45デニールのポリグリコール酸マルチフィラメント繊維(コネチカット州コベントリ所在のTeleflex Medical社)、および90デニールのポリグリコール酸マルチフィラメント繊維(コネチカット州コベントリ所在のTeleflex Medical社)を二重ニードル・バー編み機(ドイツ、Oberlshausen所在の、Karl Mayer Textimaschinenfabrik GmbH社)に導入した。図2A〜図2Cを参照すると、表面上に実質的にポリ(グリコール)酸からできている層(図2C)、裏面上に実質的にポリプロピレンでできている層(図2B)、および2つの層を一緒に接続しているポリグリコール酸バインダー繊維(図2A)を有するメッシュが示されている。このメッシュは、下記のバー・パターンで、ペンシルバニア州パーカシー所在のSecant Medical社によって、繊維を一緒に編組することによって生成された。
癒着バリア20の前駆体を含む液剤を下記のように製造した。最初に、懸濁液を作るために、米国特許第5,017,229号および第5,527,893号の記述により調製した1グラムの変性し、照射したヒアルロン酸/カルボキシメチルセルロース(HA/CMC)の粉末を、大きなセン断力の下で86グラムの脱イオン水と混合した。次に、アクリル酸エステル(20kTLA2)で末端がキャップされた、米国特許第6,177,095号に記載のポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーをベースとする2.5グラムの光重合することができる化合物の粉末を懸濁液と混合した。次に、40ppmのエオシンY、光開始剤、4,000ppmのN−ビニルカプロラクタム、促進剤、0.54グラムのトリエタノールアミン、緩衝剤、および電子移動成分、および0.8グラムのリン酸カリウム、第2の緩衝剤を懸濁液と混合した。液剤を終了する目的で、最終量を100グラムにするために追加の脱イオン水を加えた。
一方の面が組織を内側に向けて生長させるためのものであり、他方の面が癒着防止特性を有する柔組織修復用の外科用プロテーゼを形成するために、実施例1に記載したメッシュを例2に記載した癒着バリアと結合した。
実施例3で作った外科用プロテーゼを、擦剥した腸によりウサギのヘルニアの治療モデ
ル内で評価した。
56.7平方センチメートルの面積を有するポリスチレンの皿内の10〜12mlの液剤内に、実施例1に記載したメッシュの生分解性ポリグリコン酸側を浸すことにより外科用プロテーゼを調製した。液剤の場合には、90グラムの水内の2グラムのカルボジイミ
ド変性HA/CMC粉末を100グラムの脱イオン水内の5%20kTLA2マクロマーと混合した。脱イオン水内の40ppmのエオシンY、4000ppmのN−ビニルカプロラクタム、1.08グラムのトリエタノルアミン、および1.6グラムのリン酸カリウムからなる追加溶液を加えて、最終量を200グラムにした。
2.5%の20kTLA2、40ppmのエオシンY、4000ppmのN−ビニルカプロラクタム、0.54%のトリエタノルアミン、0.8%のリン酸カリウム、および1%のカルボジイミド変性HA/CMCの液剤を調製し、32mlの液剤を32平方インチのガラス板の上に広げた。実施例1のメッシュを生分解性ポリグリコール酸側を下にして液剤内に浸した。液剤を4分間約4mW/cm2の輝度を有する発光ダイオードのアレイにより照射することにより光重合させた。ヒドロゲルで補強された結果として得られたメッシュを、ガラス板を除去する前に、4時間の間50℃で空気乾燥した。次に、補強したメッシュを外科用プロテーゼを形成するために7時間100℃で脱水した。
実施例6の外科用プロテーゼの外科処理特性を試験した。外科用プロテーゼの腹腔鏡臨床用途をシミュレートするために、大人の豚の腹部−骨盤腔を使用した。
9.4mg/cm2の質量面積を有し、6ミルのポリプロピレン繊維からできている1つのアトラス・ポリプロピレン・メッシュに、約7mg/cm2の質量/面積を有し、厚さ約1ミリメートルのポリグリコール酸(PGA)不織フェルト織物を一緒に縫いつけることにより外科用プロテーゼ用メッシュを形成した。PGA不織フェルト織物は、Scaffix International社(マサチューセッツ州ドーバ所在)から入手し、1つのアトラス・ポリプロピレン・メッシュはGenzyme Biosurgery社(マサチューセッツ州フォールリバー所在)から入手した。
実施例8のプロセスにより外科用プロテーゼ用メッシュを形成した。Genzyme社(マサチューセッツ州フレーミングハム所在)から入手した2.3%のカルボジイミド変性HA/CMC、および0.073mlのグリセロール、可塑剤を含む12グラムの懸濁液を含む56.7cm2のポリスチレン皿に不織フェルト織物側を下にして浸した。皿は懸濁液を含み、メッシュを一晩空気乾燥した。
ルを加熱した。加水した場合、外科用プロテーゼの1つの面上でHA/CMCの親水性を有する潤滑な層が視覚により認識できた。最初の加水後および室温での24時間の水への浸漬の後で、外科用プロテーゼは優れたウェット取り扱い特性を示した。加水したサンプルを親指と人差し指の間で強く擦ったが剥離が起こらず、手で剥離することができなかった。
実施例8のプロセスにより外科用プロテーゼ用メッシュを形成した。20kTLA2、40ppmのエオシンY、4000ppmのN−ビニルカプロラクタム、0.54%のトリエタノルアミン、0.8%のリン酸カリウム、および5%のヒアルロン酸の5mlの5%溶液を有する56.7cm2のポリスチレン皿内に、不織フェルト織物側を下にして浸した。次に、Genzyme Biosurgery社(マサチューセッツ州レキシントン所在)から入手したキセノン光源から4回の40秒サイクルで、溶液を光重合させてヒドロゲルにした。
(実施例11)
9.4mg/cm2の質量面積比を有し、6ミルのポリプロピレン繊維からできていて、Genzyme Biosurgery社(マサチューセッツ州フォールリバー所在)から入手した1つのアトラス・ポリプロピレン・メッシュに、ポリグラクチン910、ポリグリコール酸およびポリ酢酸繊維のコポリマーからできていて、Ethicon社(ニュージャージー州ニューブランズウィック所在)から入手したVicryl(登録商標)編みメッシュを一緒に縫いつけることにより外科用プロテーゼ用メッシュを形成した。
Claims (49)
- 外科用プロテーゼであって、
少なくとも2つの層を形成するために相互にルーピングしているか相互に絡み合っている少なくとも2つのタイプの糸を含む三次元メッシュであって、前記少なくとも2つの層のうちの一方が実質的に非生分解性であり、前記少なくとも2つの層のうちの他方が、実質的に生分解性である三次元メッシュと、
また前記三次元メッシュの第2の実質的に生分解層と相互に接続している癒着バリアとを備える外科用プロテーゼ。 - 前記少なくとも2つのタイプの糸の一方が非生分解性糸である請求項1に記載の外科用プロテーゼ。
- 前記非生分解性糸が、ポリプロピレン、ポリエチレン・テレフタレート、またはこれらの組合せから選択される請求項2に記載の外科用プロテーゼ。
- 前記非生分解性糸が、約0.005インチの直径を有する請求項2に記載の外科用プロテーゼ。
- 前記少なくとも2つのタイプの糸の一方が生分解性糸である請求項1に記載の外科用プロテーゼ。
- 前記生分解性糸が、ポリ(グリコール)酸、ポリ酢酸、ポリジオキサノン、ポリカプロラクトン、アルギン酸カルシウムまたはこれらの組合せから選択される請求項5に記載の外科用プロテーゼ。
- 前記生分解性糸が、約90デニール程度の直径を有する請求項5に記載の外科用プロテーゼ。
- 前記三次元メッシュが、少なくとも1つの非生分解性モノフィラメント糸と、少なくとも1つの生分解性マルチフィラメント糸とを含む請求項1に記載の外科用プロテーゼ。
- 前記癒着バリアが架橋ポリマー・ヒドロゲルを含む請求項1に記載の外科用プロテーゼ。
- 前記癒着バリアが、カルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類を含む請求項1に記載の外科用プロテーゼ。
- 前記癒着バリアが、架橋ポリマー・ヒドロゲルと、カルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類とを含む請求項1に記載の外科用プロテーゼ。
- 前記架橋ポリマー・ヒドロゲルが、1つまたは複数の親水性ブロックと、1つまたは複数の生分解性ブロックと、1つまたは複数の架橋ブロックとを含む請求項11に記載の外科用プロテーゼ。
- 前記架橋ポリマー・ヒドロゲルが、アクリル酸エステルにより末端がキャップされた光重合性ポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーを含むモノマーの光重合により形成される請求項11に記載の外科用プロテーゼ。
- カルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類が、カ
ルボジイミドで変性されたヒアルロン酸と、カルボジイミドで変性されたカルボキシメチルセルロースとを含む請求項11に記載の外科用プロテーゼ。 - 前記癒着バリアが、フィルムまたはフォームの形をしている請求項1に記載の外科用プロテーゼ。
- 前記癒着バリアが、ゲルの形をしている請求項1に記載の外科用プロテーゼ。
- 前記外科用プロテーゼが、約2%以下の含水率を有する請求項1に記載の外科用プロテーゼ。
- 前記外科用プロテーゼが、約1.2%以下の含水率を有する請求項1に記載の外科用プロテーゼ。
- 前記癒着バリアが、平方フィート当たり約5グラムの全ポリマーの密度を有する請求項1に記載の外科用プロテーゼ。
- 外科用プロテーゼであって、
非生分解性糸から実質的に形成されている第1の層であって、前記外科用プロテーゼの第1の外面を形成している第1の層と、
第1の生分解性糸から実質的に形成されている第2の層であって、第2の生分解性糸を含む前記第1の層に接続している第2の層と、
前記第2の層内に埋め込まれている癒着バリアであって、前記外科用プロテーゼの第2の外面を形成している癒着バリアとを備え、
前記外科用プロテーゼの前記第1の外面が、組織が前記第1の層内に生長することができるマクロ多孔性構造を有し、前記外科用プロテーゼの前記第2の外面が、前記第2の外面に隣接する組織の癒着の形成を最小限度にすることができる外科用プロテーゼ。 - 前記外科用プロテーゼの前記第2の外面が微多孔性である請求項記20に記載の外科用プロテーゼ。
- 前記マクロ多孔性構造が、約100ミクロン以上の孔部サイズを有する請求項記20に記載の外科用プロテーゼ。
- 前記非生分解性糸が、ポリプロピレン、ポリエチレン・テレフタレート、またはこれらの組合せから選択される請求項記20に記載の外科用プロテーゼ。
- 前記第1の生分解性糸が、ポリ(グリコール)酸、ポリ酢酸、ポリジオキサノン、ポリカプロラクトン、アルギン酸カルシウムまたはこれらの組合せから選択される請求項20に記載の外科用プロテーゼ。
- 前記第2の生分解性糸が、ポリ(グリコール)酸、ポリ酢酸、ポリジオキサノン、ポリカプロラクトン、アルギン酸カルシウムまたはこれらの組合せから選択される請求項20に記載の外科用プロテーゼ。
- 前記バリアが、架橋ポリマー・ヒドロゲル、およびカルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類を含む請求項20に記載の外科用プロテーゼ。
- 前記架橋ポリマー・ヒドロゲルが、1つまたは複数の親水性ブロックと、1つまたは複数
の生分解性ブロックと、1つまたは複数の架橋ブロックとを含む請求項26に記載の外科用プロテーゼ。 - 前記架橋ポリマー・ヒドロゲルが、アクリル酸エステルにより末端がキャップされた光重合性ポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーを含むモノマーの光重合により形成される請求項26に記載の外科用プロテーゼ。
- カルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類が、カルボジイミドで変性されたヒアルロン酸と、カルボジイミドで変性されたカルボキシメチルセルロースとを含む請求項26に記載の外科用プロテーゼ。
- 外科用プロテーゼを製造するための方法であって、
実質的に非生分解性糸からできている第1の層、および生分解性糸からできている第2の層を含む織物を供給するステップと、
マクロマーおよび開始剤を含む液剤を供給するステップと、
前記第2の層が前記液剤と流体接触するように前記液剤内に織物を入れるステップと、
前記液剤を光源で照射するステップとを含む方法。 - 前記開剤が光開始剤である請求項30に記載の方法。
- 前記光開始剤がエオシンYを含む請求項31に記載の方法。
- 前記液剤が、生体高分子と、促進剤と、緩衝剤とをさらに含む請求項30に記載の方法。
- 前記生体高分子が、カルボジイミドとの反応により変性された少なくとも1つのポリアニオン性多糖類を含む請求項33に記載の方法。
- 前記緩衝剤がトリエタノルアミンを含む請求項33に記載の方法。
- 前記緩衝剤がリン酸カリウムを含む請求項33に記載の方法。
- 前記促進剤がN−ビニルカプロラクタムを含む請求項33に記載の方法。
- 前記液剤が、1重量%のカルボジイミド変性ヒアルロン酸およびカルボキシメチルセルロースと、アクリル酸エステルにより末端がキャップされた2.5重量%のポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーと、40ppmのエオシンY、4000ppmのN−ビニルカプロラクタムと、0.54重量%のトリエタノルアミンと、0.8重量%のリン酸カリウムとを含む請求項30に記載の方法。
- 前記光源が、約1〜約100mW/cm2の輝度を有するLEDアレイである請求項30に記載の方法。
- 外科用プロテーゼを製造するための方法であって、
実質的に非生分解性糸からできている第1の層、および生分解性糸からできている第2の層を含む織物を供給するステップと、
第1の高分子系、第2の高分子系および光開始剤を含む液剤を供給するステップと、
前記第2の層が液剤と流体接触するように、前記液剤上に織物を置くステップと、
前記液剤内の前記高分子系のうちの少なくとも一方を重合させる目的で、光開始剤を作動させるために前記液剤を光源で照射するステップとを含む方法。 - 前記高分子系のうちの少なくとも1つの重合により、前記織物の前記第2の層内に一部が埋め込まれているバリア層が形成される請求項40に記載の方法。
- 前記第1の高分子系が、カルボジイミド変性ヒアルロン酸およびカルボジイミド変性カルボキシメチルセルロースを含み、前記第2の高分子系が、アクリル酸エステルにより末端がキャップされたポリ(エチレン・グリコール)−炭酸トリメチレン/乳酸系マルチブロック・ポリマーを含む請求項41に記載の方法。
- 前記光開始剤がエオシンYを含む請求項42に記載の方法。
- 前記液剤が、促進剤および少なくとも1つの緩衝剤をさらに含む請求項43に記載の方法。
- 前記液剤が、第1の緩衝剤および第2の緩衝剤をさらに含む請求項44に記載の方法。
- 前記促進剤がN−ビニルカプロラクタムを含み、前記第1の緩衝剤がトリエタノルアミンを含み、前記第2の緩衝剤がリン酸カリウムを含む請求項45に記載の方法。
- 前記光源が、約1〜約100mW/cm2の輝度を有するLEDアレイである請求項40に記載の方法。
- コンベクション・オーブン内で前記織物および前記バリア層を乾燥するステップをさらに含む請求項41に記載の方法。
- 患者の体腔を囲む壁部内の開口部を治療するための方法であって、
請求項1に記載の外科用プロテーゼを供給するステップと、
癒着バリアが癒着を防止する内臓または組織の方を向くように、前記患者の前記壁部開口部上の前記外科用プロテーゼを固定するステップとを含む方法。
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EP (1) | EP1744796B1 (ja) |
JP (1) | JP4977600B2 (ja) |
CN (1) | CN101035574B (ja) |
AU (2) | AU2005237985B2 (ja) |
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BRPI0510042B1 (pt) | 2017-04-25 |
US20130045327A1 (en) | 2013-02-21 |
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US8460695B2 (en) | 2013-06-11 |
EP1744796B1 (en) | 2015-03-18 |
CN101035574B (zh) | 2011-05-11 |
US8323675B2 (en) | 2012-12-04 |
AU2005237985B2 (en) | 2010-10-21 |
US20050244455A1 (en) | 2005-11-03 |
JP4977600B2 (ja) | 2012-07-18 |
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WO2005105172A1 (en) | 2005-11-10 |
AU2011200200B2 (en) | 2011-12-22 |
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