Biodegradable medical device for breast reconstruction and/or augmentation

Abstract

An implantable biodegradable medical device arranged for breast reconstruction and / or augmentation, made of an interconnected porous structured polymeric matrix and belonging to the family of poly(urea urethane)s.The porous structured polymeric matrix of the medical device comprises a plurality of three dimensional channels, drilled by means of heated tools, three-dimensionally propagating through the polymeric matrix ad interconnected with the porous structure of the polymeric matrix.The polymeric matrix comprises high to-medium molecular weight hydrophobic biodegradable amorphous soft segments polyols, having average molecular weight comprised between 20,000 and 60,000 Da, hydrophilic polyalkoxide polyols, of average molecular weight comprised between 2,000 and 15,000 Da, and low molecular weight polyisocyanates and polyols, whose average molecular weights range between 15 and 200

Description

RELATED APPLICATIONS[0001]This application is a United States national phase application under 35 USC § 371 of PCT / IB2016 / 055238 filed on Sep. 1, 2016, and claims the benefit under 35 USC § 119 of Italian patent application number 102015000047951 filed Sep. 2, 2015, the disclosures of which are both incorporated herein by reference in their entireties.TECHNICAL FIELD[0002]Present invention relates, in general, to the field of regenerative medicine for soft tissues reconstruction.More specifically, the invention relates to an implantable biodegradable or bioresorbable medical device for breast reconstruction and / or augmentation.BACKGROUND ART[0003]In the field of regenerative medicine, soft tissues reconstruction is generally known and, in particular, breast reconstruction is known.[0004]Breast reconstruction aims to restore a breast to near normal shape, appearance and size, following mastectomy, quadrantectomy or lumpectomy, through several plastic surgeries.[0005]The high incidenc...

AI Technical Summary

Benefits of technology

The invention is a medical device with a unique structure that allows for fast and effective cell penetration and blood vessel formation. It has a high level of interconnectedness and can be produced in a simple and scalable process.

Problems solved by technology

The known reconstructive options are so far limited to whole breast saline or silicone non-resorbable implants.

Due to the fact that it is difficult to treat a wide variety of soft tissue deficits resulting from quadrantectomy or lumpectomy procedures in patients, according to the known prior art there are very few reconstructive options for these patients.

Another constraint of the known non-resorbable implants is the perception that cancer might not be detected if the area is covered by such non-resorbable implants, which could hide suspicious lesions or rupture in the implants during screening.

Transplantation of autologous adipose tissue fraction (“free-fat grafting”) rarely achieves sufficient tissue augmentation because of delayed neovascularization of the grafted adipose tissue, with consequent cell necrosis, and graft volume shrinkage, losing up to 60% of its volume after transplantation.

However the substitutes so far obtained are dimensionally limited, due to the lack of vascularization and efficient transportation of nutrients and oxygen to inner core of the scaffold.

Limitations of the employment of natural polymers in the development of medical devices which aim to regenerate adipose tissue are mainly related to their elevated costs, variable quality from batch-to-batch, expensive isolation processes and the possibility to cause immune response, due to endotoxins belonging to their allogenic or xenogenic origin.

Currently, the most common limits against the employment of porous synthetic polymers in adipose tissue regeneration are related to their physico-chemical properties, such as mechanical properties, hydrophilic character, and degradation kinetics, which do not exactly match all the requirements of adipose tissue ingrowth in vivo.

According to prior art, the employment of polyurethane foams in implantable medical device for breast surgery, is so far limited to the enhancement of biocompatibility of silicon-based breast prostheses, through surface coating of the latter by thin layers of polyurethane foam.

Applicant has noticed that cross-linked polyurethane foams disclosed in the above documents do not have the mechanical properties required for soft tissue regeneration; in particular, according to the above prior art documents, is not possible to obtain soft foams, having compressive moduli comprised between 5 to 700 kPa.

However, the Applicant has found that all these techniques present different limitations when used for the fabrication of channelized porous scaffolds at industrial scale; these limitation are related to scalability, cost, complexity and compatibility with different biomaterials.

In particular, for sacrificial methods 1) the limitations are related to:

ii) difficulties to obtain homogeneous pores around the sacrificial templates, especially when the porous scaffold is obtained by foaming;

iii) impossibility to obtain complex three-dimensional sacrificial template networks, when the template networks are produced by injection molding;

iv) difficulties to obtain three-dimensional sacrificial template networks by 3D printing of thermo-plastic polymers, due to the collapse of the filaments during polymer deposition (to this purpose, it would be necessary to assemble several 2D templates, which rendered the process more complicated and less versatile).

With regard to the injection molding 2), despite being the most adopted process for polymers shaping on industrial scale, it is not suitable for the production of complex three-dimensional channels inside soft polymeric foams, due to the inevitable alteration of the porous structure and the formation of thin non-porous films in proximities of the mold walls, which are usually called “skin”.

For phase separation methods 3), the limitations are related to the prolonged passages to eliminate solvent / non-solvents, which may alter the scaffolds physico-chemical properties in addition to the lack of versatility of the process.

i) the high power consumption, and consequently the elevated process cost;

i) high manufacturing costs

ii) limited choice of materials usable

iii) limited scalability due a general slowness of the production process compared with other techniques.

As for common drilling techniques 6), they cannot be applied to soft and flexible porous polymeric matrixes, since the only use of a mandrel to perforate the porous matrix is not able to create stable channels or cavities, due to deformation and the collapse of the latter, under the effect of the local compression force exerted by the mandrel during perforation.

However, this technique cannot be applied to most porous biomaterials, since the cells are grown directly on the mandrel before the formation of the solid gel matrix constituting the scaffold and most porous biomaterial synthetic processes do not allow the presence of cells during the curing phase.

In this case, the formation of a parent vessel needs a channel having a continuous wall, without pores or holes, therefore it would not be possible on a channel highly interconnected with pores in a porous biomaterial.

Applicant has also noticed that the most popular current solutions for breast reconstruction can only fill volume deficit after trauma or tumor resection and are not able to effectively:

Images