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Acta veterinaria Scandinavica2023; 65(1); 48; doi: 10.1186/s13028-023-00710-0

A preliminary investigation of the subcutaneous tissue reaction to a 3D printed polydioxanone device in horses.

Abstract: A 3D printed self-locking device made of polydioxanone (PDO) was developed to facilitate a standardized ligation technique. The subcutaneous tissue reaction to the device was evaluated after implantation in ten horses of mixed age, sex and breed and compared to loops of poly(lactic-co-glycolic acid) (PLGA). In two of the horses, the implants were removed before closing the skin. The appearance of the implants and surrounding tissue was followed over time using ultrasonography. Implants were removed after 10 and 27 (± 1) days for histologic examination. Results: On macroscopic inspection at day 10, the PDO-device was fragmented and the surrounding tissue was oedematous. On ultrasonographic examination, the device was seen as a hyperechoic structure with strong acoustic shadowing that could be detected 4 months post-implantation, but not at 7 months. Histology revealed a transient granulomatous inflammation, i.e., a foreign body reaction, which surrounded both PDO and PLGA implants. The type and intensity of the inflammation varied between individuals and tissue category. Conclusions: The 3D printed PDO-device caused a transient inflammatory reaction in the subcutaneous tissue and complete resorption occurred between 4 and 7 months. Considering the intended use as a ligation device the early fragmentation warrants further adjustments of both material and the 3D printing process before the device can be used in a clinical setting.
© 2023. The Author(s).
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Publication Date: 2023-11-20 PubMed ID: 37986118PubMed Central: PMC10659009DOI: 10.1186/s13028-023-00710-0Google Scholar: Lookup
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Summary

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The research article discusses a preliminary study on the reaction of subcutaneous tissue in horses after the implantation of a 3D printed device using polydioxanone (PDO). The study finds that the device causes a temporary inflammatory response in the tissue and has fully absorbed between 4 to 7 months.

Introduction

  • The researchers developed a 3D printed self-locking device composed of polydioxanone (PDO).
  • Its purpose was to facilitate a standardized ligation technique, which is a surgical procedure involving the tying off of blood vessels or ducts.
  • The study aimed to assess the subcutaneous tissue reaction of horses to this device by comparing the reactions with those to loops of poly(lactic-co-glycolic acid) (PLGA).

Methodology

  • The test was performed on ten horses with varied age, sex and breed.
  • Two of the horses had the implants removed before the skin was closed.
  • These implanted devices and their surrounding tissue were observed over time using ultrasonography – a diagnostic imaging technique which uses ultrasound waves to visualize subcutaneous body structures.
  • The implants were removed after 10 and 27 days for histologic examination – a microscopic examination of biological tissues to observe the appearance of disease.

Results

  • On the 10th day macroscopic inspection, it was found that the PDO devices had fragmented and surrounding tissue had turned oedematous (swollen because of excess fluid).
  • In ultrasonographic examination, the device was seen as a hyperechoic structure with significant acoustic shadowing, detectable till 4 months post-implantation and undetectable at 7 months.
  • Studies revealed a temporary granulomatous inflammation, meaning an inflammation that forms granulomas (small areas of inflammation) which is a type of foreign body reaction, surrounding both PDO and PLGA implants.

Conclusions

  • Overall, the use of the 3D printed PDO device resulted in a temporary inflammatory reaction in the subcutaneous tissue of horses.
  • The device was completely absorbed in the tissue between 4 and 7 months after implantation.
  • However, due to early fragmentation found in the study, the researchers concluded that both the material and the 3D printing process need adjustments before it can be utilized in a clinical setting.

Cite This Article

APA
Sjöberg I, Law E, Södersten F, Höglund OV, Wattle O. (2023). A preliminary investigation of the subcutaneous tissue reaction to a 3D printed polydioxanone device in horses. Acta Vet Scand, 65(1), 48. https://doi.org/10.1186/s13028-023-00710-0

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 65
Issue: 1
Pages: 48
PII: 48

Researcher Affiliations

Sjöberg, Ida
  • Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences (SLU), Box 7054, Uppsala, S-750 07, Sweden. ida.sjoberg@slu.se.
Law, Ellen
  • Diagnostic Imaging Clinic, University Animal Hospital, SLU, Uppsala, Sweden.
Södersten, Fredrik
  • Department of Biomedical Sciences and Veterinary Public Health, Faculty of Veterinary Medicine and Animal Science, SLU, Uppsala, Sweden.
Höglund, Odd Viking
  • Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences (SLU), Box 7054, Uppsala, S-750 07, Sweden.
Wattle, Ove
  • Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences (SLU), Box 7054, Uppsala, S-750 07, Sweden.

MeSH Terms

  • Animals
  • Horse Diseases
  • Horses / surgery
  • Inflammation / veterinary
  • Ligation / methods
  • Ligation / veterinary
  • Polydioxanone
  • Printing, Three-Dimensional
  • Subcutaneous Tissue / surgery
  • Male
  • Female

Conflict of Interest Statement

OVH is the inventor of the self-locking device and founder of company Resorbable Devices AB. The company holds the associated patents but the inventor performed neither the analysis nor interpretation of data. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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