Biodegradable Films in Trauma and Orthopedic Surgery

• Published in: European journal of trauma 2006-04, Vol.32 (2), p.160-171
• Main Authors: Jürgens, Christian, Schulz, Arndt Peter, Porté, Thomas, Faschingbauer, Maximilian, Seide, Klaus
• Format: Article
• Language: English
• Subjects: Biodegradable materials; Biomedical materials; Biomedical research; Cellular biology; Transplants & implants
• ISSN: 1439-0590; 1863-9933; 1615-3146; 1863-9941
• DOI: 10.1007/s00068-006-6051-z

Resorbable materials have gained a considerable position in the daily routine of all surgical disciplines. Natural products like catgut and collagen have been used historically. Since the development of synthetical macromolecules more than 40 years ago, the range of indications for the use of such materials has widened significantly in our daily routine. Suture materials, mesh, tissue pads, clips, screws and anchors are in use. More recent developments in the field of orthopedic and trauma surgery include screw-plate systems, wound dressing materials and films for the prevention of adhesions and ossifications. This appears to be the beginning of an era of new materials as these implants not only fulfil a temporary biomechanical role but in theory also can release a controlled amount of biologically active substances at a set timeframe. Also they are potential carriers for transplants on a cellular level. This aspect will be of importance in the orthopedic field, where resorbable films only play a minor role so far. At the moment there are six resorbable or biodegradable films or foils on the market that are used or can be used in the field of orthopedic and trauma surgery. These are foils and films made of following materials: carboxy-methyl-cellulose and hyaloronic acid (Seprafilm), oxydized regenerated cellulose (Interceed), polydioxanon (PDS) and copolymers of lactid und caprolacton (Topkin, Oprafol, Mesofol). Main indications for their use are wound dressing, especially after split skin graft and thermal wounds, prophylaxis of adhesions and prevention of the formation of synostoses and heterotopic ossifications. The results of clinical trials are promising and the increasing number of publications in the last 5 years in this field is an expression of increasing demand of these materials. However, it could also be an expression of the growing interest in drug delivery techniques as well as in tissue engineering which are possible with these materials. [PUBLICATION ABSTRACT]