使用超柔性导线进行能量传递的耐用机械循环系统降低传动系统感染风险。

IF 6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Andreas P Kourouklis, Xi Wu, Julius Kaemmel, Sanne Hertegonne, Srikanth Mairpady Shambat, Mihyun Lee, Christian Grossmann, Raphael Hagen, Daniel Fehr, Fabrizio Spano, Carolina Pietsch, Simone de Brot, Nikola Cesarovic, Qun Ren, Mathias Bonmarin, Miriam Weisskopf, Annelies S Zinkernagel, Evgenij Potapov, Volkmar Falk, Edoardo Mazza
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引用次数: 0

摘要

背景:动力传动系统感染(DLIs)是由耐用机械循环支持装置(dMCSs)支持的心力衰竭患者的负担。造成DLI的一个主要因素是传动系统的机械顺应性低,影响伤口愈合。减轻皮肤机械压力的新型传动系统可能会降低DLI的风险。我们研究了低弯曲刚度钢丝对DLI风险的宏观和微观影响。方法:利用超柔丝的绞合金属芯和直径小,经皮植入dMCS成年羊模型,并进行dMCS手术的典型电条件。对照组(未接种细菌,n=2只动物,随访2个月)和接种组(接种表皮葡萄球菌,n=2只动物,随访1.5个月)在每只动物的等效手术部位植入商业化dMCS传动系统和原型。接种组手术部位在植入后2周感染表皮葡萄球菌。结果:超柔丝具有完美的机电性能,使皮肤红肿在头两周内迅速恢复。结论:使用小而超柔的丝可减小创面尺寸和出口部位的机械应力,增强屏障功能,降低DLI风险。超柔丝的使用可以改善dMCS患者的生活质量和持续时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing driveline infection risk in durable mechanical circulatory support devices with ultra-flexible wires for energy transfer.

Background: Driveline infections (DLIs) pose a burden to heart failure patients supported by durable mechanical circulatory support devices (dMCSs). A major factor to DLI comes from the low mechanical compliance of drivelines, affecting wound healing. New drivelines that mitigate mechanical stress on skin may reduce the risk of DLI. We investigate macroscopic and microscopic effects of wires with low flexural stiffness on the risk of DLI.

Methods: Prototypes equipped with ultra-flexible wires, due to their stranded metallic core and small diameter, were percutaneously implanted in an adult ovine model of DLI and subjected to electric conditions typical of dMCS operation. In the control (no bacterial inoculation, n=2 animals, follow-up period around 2 months) and inoculation (with Staphylococcus epidermidis, n=2 animals, follow-up period 1.5 months) study groups, the commercial dMCS drivelines and the prototypes were implanted at equivalent surgical sites of each animal. In the inoculation group, the surgical sites were infected with Staphylococcus epidermidis 2 weeks post-implantation.

Results: Ultra-flexible wires showed flawless electromechanical performance, enabled fast recovery of skin redness in the first 2 weeks (p<0.05), and reduced inflammation (p<0.0001) at the exit site compared to commercial dMCS drivelines. After S. epidermidis inoculation at the exit site, ultra-flexible wires displayed reduced bacterial number (34 times lower) compared to commercial dMCS drivelines, avoiding internal biofilm formation and macroscopic signs of infection.

Conclusions: Using small, ultra-flexible wires reduced wound size and mechanical stress at the exit site, strengthening barrier function and lowering the risk of DLI. The use of ultra-flexible wires may improve the quality and duration of life of patients supported with dMCS.

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来源期刊
CiteScore
10.10
自引率
6.70%
发文量
1667
审稿时长
69 days
期刊介绍: The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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