Abstract
Self-inflating soft tissue expanders represent a valuable modality in reconstructive surgery. For this purpose, particularly synthetic hydrogels that increase their volume by swelling in aqueous environment are used. The current challenge in the field is to deliver a material with a suitable protracted swelling response, ideally with an induction period (for sutured wound healing) followed by a linear increase in volume lasting several days for required tissue reconstruction. Here, we report on synthesis, swelling, thermal, mechanical and biological properties of novel hydrogel tissue expanders based on poly(styrene-alt-maleic anhydride) copolymers covalently crosslinked with p-divinylbenzene. The hydrogels exerted hydrolysis-driven swelling response with induction period over the first two days with minimal volume change and gradual volume growth within 30 days in buffered saline solution. Their final swollen volume reached more than 14 times the dry volume with little dependence on the crosslinker content. The mechanical coherence of samples during swelling and in their fully swollen state was excellent, the compression modulus of elasticity being between 750 and 850 kPa. In vitro cell culture experiments and in vivo evaluation in mice models showed excellent biocompatibility and suitable swelling responses meeting thus the application requirements as soft tissue expanders.
Highlights
The soft tissue expanders (TE) prepared from swelling gels represents a useful modality in reconstructive surgery especially in the maxillofacial area
In our previous study [17] we presented the synthesis of TEs in form of a solid and uniform hydrogel blocks without any membrane cover based on poly(2-hydroxyethyl methacrylate-co-methacrylic acid) copolymers
The maleic anhydride (MA) is known not to homopolymerize but it copolymerizes with the other monomers of the opposite electron polarization, e.g., vinyl monomers such as styrene
Summary
The soft tissue expanders (TE) prepared from swelling gels represents a useful modality in reconstructive surgery especially in the maxillofacial area. The surgical use of bone grafts (e.g., alveolar bone graft) is essential in the treatment of many pathologies, but it is often difficult due to periosteal deficiency that often leads to the necessity of grafting soft tissue prior to bone surgery. Keeping the living tissue under a constant tension created by TE leads to the growth of cells and tissue [1]. The periosteum is responsible for the bone growth and its presence on the surface is crucial for bone reconstruction [2]. The use of subperiosteal TE is able to produce excess periosteal tissue and lead to success in clinical setting [3]. TE have many advantages: They allow better wound closure without compromising the blood supply of the flap, they help to augment the bone and their transfer is safer due to higher vascularization [4,5]
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