A 'tissue engineering' strategy to improve the clinical performance of percutaneous implants (NKG.5378)

Implants that permanently penetrate the skin are used in a variety of clinical applications, e.g. catheters used in continuous ambulatory peritoneal dialysis (CAPD). The use of such devices is associated with several problems. In general though, the catheter exit-site can be regarded the "Achilles heel" of this type of devices. Although progress has been made in the last decade, it has become obvious that the formation of a stable skin-implant junction in the exit-site is the only final way to prevent implant failure. This suggestion is supported by what we know about the maintenance and failure mechanism of natural percutaneous structures, like teeth. Until recently, mimicking the gingival attachment apparatus to achieve a natural exit-site for percutaneous devices seemed a Utopian scenario. However, with the current developments in biomedicine, especially in the field of "tissue engineering", this goal now seems feasible. With tissue engineering techniques, it should be possible to create a ligament-like structure that can preserve its integrity over long periods of time. In this project we aim to investigate the possibilities of constructing such a structure, and to evaluate it in an animal model. For this, we intend to (1) use tissue engineering of ectopic bone to improve the stability of percutancous catheters, (2) determine the optimal surface texture size to support soft tissue organisation and to impede epidermal ingrowth, (3) produce a periodontal ligament-like structure to support the regeneration of a connective tissue attachment apparatus around percutaneous catheters, and (4) evaluate tissue healing around a catheter equipped with the tissue engineered constructs.

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Er zijn vijf bedrijven, twee ziekenhuizen en één andere universiteit bij dit project betrokken.