WO2016136884A1 - 医療用材料及び癒着防止材 - Google Patents
医療用材料及び癒着防止材 Download PDFInfo
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- WO2016136884A1 WO2016136884A1 PCT/JP2016/055654 JP2016055654W WO2016136884A1 WO 2016136884 A1 WO2016136884 A1 WO 2016136884A1 JP 2016055654 W JP2016055654 W JP 2016055654W WO 2016136884 A1 WO2016136884 A1 WO 2016136884A1
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- water
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- polyanionic polysaccharide
- medical material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/28—Materials for coating prostheses
- A61L27/34—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/042—Polysaccharides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/64—Use of materials characterised by their function or physical properties specially adapted to be resorbable inside the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/56—Porous materials, e.g. foams or sponges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/58—Materials at least partially resorbable by the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/12—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/148—Materials at least partially resorbable by the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
- A61L2300/23—Carbohydrates
- A61L2300/236—Glycosaminoglycans, e.g. heparin, hyaluronic acid, chondroitin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
- A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
- A61L2300/424—Anti-adhesion agents
Definitions
- the present invention relates to a medical material and an adhesion prevention material.
- Polyanionic polysaccharides such as hyaluronic acid and alginic acid are known to exhibit moderate viscosity, tackiness, moisture retention, and biocompatibility. For this reason, these polyanionic polysaccharides and salts thereof are widely used as raw materials for medical materials, food materials, cosmetic materials and the like.
- hyaluronic acid is used in various applications such as foods, cosmetics, and pharmaceuticals because of its excellent physical properties such as water retention and high safety and biocompatibility.
- hyaluronic acid is used as a raw material for joint lubricants and anti-adhesion materials.
- sodium hyaluronate as a raw material has high water solubility, it is necessary to perform some insolubilization treatment depending on the application.
- Patent Document 1 describes a method for producing a water-insoluble derivative of a polyanionic polysaccharide such as hyaluronic acid or carboxymethylcellulose by a crosslinking reaction using carbodiimide.
- Patent Documents 2 and 3 describe a method for water insolubilizing polyanionic polysaccharides such as hyaluronic acid and carboxyalkyl cellulose by ionic bonding using a polyvalent cation. Furthermore, Patent Document 4 describes a method for obtaining a water-insolubilized film by ion-exchanging carboxymethyl cellulose using a metal salt.
- Patent Document 5 describes a method in which an aqueous sodium hyaluronate solution is cooled to ⁇ 20 ° C. under acidic conditions to form intramolecular crosslinks and thereby insolubilize in water.
- Patent Document 6 describes that acetylation is performed by reacting powdered hyaluronic acid and acetic anhydride in the presence of concentrated sulfuric acid.
- Patent Document 7 describes a method for producing a hyaluronic acid gel using an acidic liquid containing alcohol.
- Patent Document 1 uses a cross-linking agent, it is often difficult to apply when considering the safety of uses such as pharmaceuticals given to the human body.
- Patent Documents 2 to 4 do not describe any degree of water insolubility of the obtained film or the like.
- Patent Document 5 Furthermore, in the method described in Patent Document 5, it is necessary to adjust the pH of the sodium hyaluronate aqueous solution to about 1.2, and the viscosity increases remarkably, so that handling such as molding is difficult. In addition, since freeze-drying over a long period of time, there is also a problem in terms of power cost required for cooling. Furthermore, when the sodium hyaluronate aqueous solution is placed under acidic conditions, the viscosity increases rapidly, so that molding becomes difficult and uses may be limited. In Patent Document 5, the intramolecular cross-linked structure is confirmed, but the degree of insolubilization is not mentioned.
- Patent Document 6 does not describe any degree of water insolubility of the obtained acetylated product of hyaluronic acid. Furthermore, since the hyaluronic acid gel obtained by the method described in Patent Document 7 contains a large amount of moisture, it is difficult to lift. For this reason, it is difficult to insolubilize while maintaining the shape of the molded body.
- the present invention has been made in view of such problems of the prior art, and the object of the present invention is to retain the original characteristics of the polyanionic polysaccharide as a raw material and to perform chemical crosslinking at the time of production. It is an object of the present invention to provide a medical material and an adhesion preventing material having an appropriate strength that is high in safety because it does not require the use of an agent and can be sutured.
- a film precursor portion made of a raw material is formed by water insolubilization treatment with a treatment liquid containing a first acid anhydride
- the reinforcing material is a nonwoven fabric or woven fabric made of a biodegradable / absorbable polymer material Or a sponge-like carrier or a felt-like carrier formed by water-insolubilizing a raw material molded body made of a raw material containing a water-soluble salt of the second polyanionic polysaccharide with a treatment liquid containing the second acid anhydride Is a medical material.
- adhesion prevention material shown below is provided.
- the medical material and anti-adhesion material of the present invention retain the original characteristics of the polyanionic polysaccharide that is the raw material, and are highly safe because there is no need to use a chemical cross-linking agent at the time of manufacture. It has moderate strength possible.
- the medical material of the present invention includes a reinforcing material and a membrane portion that penetrates at least a part of the reinforcing material and is integrated with the reinforcing material.
- the film part is formed by subjecting the film precursor part to water insolubilization with a predetermined processing solution.
- membrane precursor part is formed of the raw material containing the water-soluble salt of 1st polyanionic polysaccharide.
- the first polyanionic polysaccharide is a polysaccharide having one or more negatively charged anionic groups such as a carboxy group and a sulfonic acid group in its molecular structure.
- the water-soluble salt of the first polyanionic polysaccharide is a salt in which at least a part of the anionic group in the first polyanionic polysaccharide forms a salt.
- the anionic group in the first polyanionic polysaccharide may be introduced into the polysaccharide molecule.
- the first polyanionic polysaccharide examples include carboxyalkyl cellulose such as carboxymethyl cellulose and carboxyethyl cellulose, carboxymethyl starch, carboxymethyl amylose, chondroitin sulfate (including chondroitin-4-sulfate and chondroitin-6-sulfate), Examples include hyaluronic acid, heparin, heparin sulfate, heparan sulfate, alginic acid, pectin, carrageenan, dermatan sulfate, and dermatan-6-sulfate. These 1st polyanionic polysaccharides can be used individually by 1 type or in combination of 2 or more types.
- water-soluble salt of the first polyanionic polysaccharide examples include inorganic salts, ammonium salts, and organic amine salts.
- inorganic salt examples include alkali metal salts such as sodium and potassium; alkaline earth metal salts such as calcium salts; metal salts such as zinc and iron.
- the treatment liquid used for water-insolubilizing the film precursor portion contains the first acid anhydride.
- the acid anhydride include acetic anhydride, propionic anhydride, succinic anhydride, butyric anhydride, phthalic anhydride, and maleic anhydride. Of these, acetic anhydride and propionic anhydride are preferable. These acid anhydrides can be used singly or in combination of two or more.
- the treatment liquid preferably further contains at least one medium of water and a water-soluble organic solvent, and the first acid anhydride is preferably dissolved or dispersed in this medium.
- the film precursor portion can be sufficiently and quickly insolubilized to form the film portion.
- water-soluble organic solvent examples include methanol, ethanol, propanol, dimethyl sulfoxide (DMSO), acetonitrile, and tetrahydrofuran. Of these, methanol, ethanol, and dimethyl sulfoxide are preferable. These water-soluble organic solvents can be used alone or in combination of two or more.
- the concentration of the first acid anhydride in the treatment liquid is usually 0.1 to 50% by mass, and preferably 5 to 30% by mass.
- concentration of the first acid anhydride is less than 0.1% by mass, the degree of water insolubilization of the formed film portion tends to be insufficient, or it takes a long time for water insolubilization.
- concentration of the first acid anhydride exceeds 50% by mass, the effect tends to reach a peak.
- the treatment liquid contains water as a medium from the viewpoint of sufficiently and quickly insolubilizing the membrane precursor portion. It is preferable that the content of water in the treatment liquid is such that the film precursor portion does not dissolve or swell. Specifically, the content of water in the treatment liquid is preferably 0.01 to 50% by mass, and more preferably 5 to 20% by mass. If the content of water in the treatment liquid is less than 0.01% by mass, water insolubilization may be insufficient with a solvent other than methanol. Moreover, when the content of water in the treatment liquid is more than 50% by mass, it may be difficult to maintain the shape of the formed film portion.
- the reinforcing material constituting the medical material of the present invention contains (i) a nonwoven fabric or woven fabric made of a biodegradable / absorbable polymer material, or (ii) a water-soluble salt of a second polyanionic polysaccharide.
- a raw material molded body made of the raw material is a sponge-like carrier or a felt-like carrier formed by water insolubilization treatment with a treatment liquid containing a second acid anhydride.
- the medical material of the present invention includes a reinforcing material and a membrane portion, and has a structure in which the membrane portion penetrates at least a part of the reinforcing material and is integrated with the reinforcing material, so that it has a suitable strength capable of suturing and the like.
- the thread tension of the medical material of the present invention is preferably 0.1 to 20 N / cm, more preferably 10 to 20 N / cm. If the thread tension is too low, the reinforcing material may be damaged after fixing. In addition, it is not necessary to have a significantly higher thread tension than the suture used for fixation.
- the weight per unit area of the membrane is preferably 5 to 100 g / m 2 , and more preferably 20 to 50 g / m 2 .
- the biodegradable / absorbable polymer material constituting the nonwoven fabric and woven fabric it is preferable to use at least one selected from the group consisting of polylactic acid, lactic acid-caprolactone copolymer, and polyglycolic acid.
- polylactic acid lactic acid-caprolactone copolymer
- polyglycolic acid polyglycolic acid
- the medical material of the present invention constituted by combining a reinforcing material such as a non-woven fabric made of a polymer material such as polylactic acid and a membrane portion formed using the first polyanionic polysaccharide, The characteristics of the polyanionic polysaccharide are exhibited, and an effective adhesion preventing effect can be obtained.
- the sponge-like carrier and the felt-like carrier are formed by subjecting a raw material molded body made of a raw material containing a water-soluble salt of the second polyanionic polysaccharide to water insolubilization with a treatment liquid containing the second acid anhydride.
- a 2nd polyanionic polysaccharide the thing similar to the above-mentioned 1st polyanionic polysaccharide can be used.
- the first polyanionic polysaccharide and the second polyanionic polysaccharide may be the same or different.
- the second acid anhydride the same acid anhydride as that described above can be used.
- the first acid anhydride and the second acid anhydride may be the same or different.
- a sponge-like carrier for example, an aqueous solution of a water-soluble salt of the second polyanionic polysaccharide is poured into a suitable container, and then dried or freeze-dried to form a sponge-like raw material molded body. And if this sponge-like raw material molded object is water-insolubilized with a treatment liquid containing the second acid anhydride, a sponge-like carrier can be obtained.
- the felt-like carrier can be obtained by, for example, pressing the sponge-like carrier obtained as described above.
- a reinforcing material is immersed in a raw material containing a water-soluble salt of the first polyanionic polysaccharide, and at least a part of the reinforcing material is impregnated with the raw material.
- a composite film including a reinforcing material and a film precursor portion that penetrates at least a part of the reinforcing material and is integrated with the reinforcing material is obtained.
- membrane precursor part is water-insolubilized using the process liquid containing a 1st acid anhydride and a film
- the raw material containing the water-soluble salt of the first polyanionic polysaccharide may further contain a radiopaque agent such as a contrast agent such as barium sulfate.
- the membrane precursor portion is water-insolubilized while maintaining the shape of the composite membrane.
- the method of treating the composite membrane with the treatment liquid is not particularly limited, but it is preferable to treat the treatment liquid so that the treatment liquid contacts the entire composite film and penetrates into the membrane precursor portion.
- Specific treatment methods include a method of immersing the composite film in the treatment liquid, and applying or spraying (spraying) the treatment liquid onto the composite film.
- the temperature during the water insolubilization treatment is not particularly limited as long as it does not exceed the boiling point of the treatment liquid. From the viewpoint of suppressing the degradation and modification of the polyanionic polysaccharide and suppressing the volatilization of the medium and by-products, the temperature during the water insolubilization treatment is preferably 0 to 80 ° C, and preferably 0 to 70 ° C. It is more preferable that the temperature is room temperature (25 ° C.) to 60 ° C. However, if the treatment liquid is not volatilized during the water insolubilization treatment, for example, heat treatment or a heat roller, the medical material can be obtained in a shorter time without causing degradation and modification.
- the temperature during the water insolubilization treatment is preferably 50 to 90 ° C., and the treatment time is preferably 30 minutes or less.
- the medical material of the present invention can be obtained by washing with water or a water-soluble organic solvent as necessary.
- R 1 represents the main chain of the polyanionic polysaccharide
- R 2 represents the main chain of the alcohol.
- the medical material of the present invention does not require the use of a chemical cross-linking agent during production, structures such as functional groups derived from the chemical cross-linking agent are not incorporated into the molecule. For this reason, the medical material of the present invention retains the original characteristics of the polyanionic polysaccharide as a raw material and has high safety. Therefore, the medical material of the present invention is suitable as an adhesion preventing material.
- the thickness of the medical material is not particularly limited, but is preferably 20 to 200 ⁇ m, more preferably 60 to 120 ⁇ m.
- the molecules of the polyanionic polysaccharide constituting the medical material of the present invention are not substantially crosslinked. Furthermore, a new covalent bond is not substantially formed in the polyanionic polysaccharide. However, it is presumed that physical bonds such as hydrogen bonds, hydrophobic bonds, and van der Waals forces are formed between the molecules of the polyanionic polysaccharide. The fact that such a physical bond is formed between molecules of the polyanionic polysaccharide can be confirmed by measuring an infrared absorption spectrum.
- the membrane part constituting the medical material of the present invention is stable and insoluble in a wide pH range from acidic to alkaline. However, when the membrane part constituting the medical material of the present invention is brought into contact with or immersed in an aqueous medium having a pH of 12 or more, the physical bond between molecules is dissociated and can be easily dissolved.
- the anti-adhesion material of the present invention is obtained by holding a polyhydric alcohol or a polyhydric alcohol aqueous solution on the aforementioned medical material.
- the polyhydric alcohol include ethylene glycol, diethylene glycol, polyethylene glycol, methylglycerol, polyoxyelene glycoside, maltitol, mannitol, xylitol, sorbitol, reduced starch syrup, dipropylene glycol, butylene glycol, valine, propylene glycol, Examples thereof include glycerin (glycerol), polyglycerin, and glycerin fatty acid ester.
- polyhydric alcohols used in the medical field and food field such as glycerin, xylitol, sorbitol, and low molecular weight polyethylene glycol are preferably used. These suitably used polyhydric alcohols can be obtained from the market and used as they are. As for glycerin, sorbitol, etc., it is desirable to use those suitable for the Japanese Pharmacopoeia. Glycerin is particularly preferable because it is a material that is safe enough to be used as an intravenous injection.
- Examples of the method for retaining the polyhydric alcohol or the polyhydric alcohol aqueous solution in the medical material include a method of immersing the medical material in the polyhydric alcohol or a polyhydric alcohol aqueous solution having a predetermined concentration. That is, the medical material is immersed in a polyhydric alcohol aqueous solution, and the inside of the membrane portion is replaced with the polyhydric alcohol aqueous solution, so that the polyhydric alcohol aqueous solution having a desired concentration is retained, and the desired adhesion of the present invention Preventive material can be obtained.
- the thickness of the adhesion preventing material of the present invention is not particularly limited, but is preferably 20 to 2000 ⁇ m, and more preferably 60 to 1200 ⁇ m.
- Example 1 A plant material-derived polylactic acid woven fabric (mesh count 97 / inch, opening ratio 62%, thickness 90 ⁇ m) was cut into a size of 12 cm long ⁇ 10 cm wide and laid on a stainless steel tray. Pour 30 mL of 1% sodium hyaluronate (molecular weight 800,000 Da) aqueous solution into a tray, soak it in a polylactic acid woven fabric, and dry it in a constant temperature bath at 20 ° C. to form a polylactic acid woven fabric-sodium hyaluronate composite Got. The obtained composite membrane is immersed in a treatment solution (20% acetic anhydride / 80% ethanol solution) and left to stand at 50 ° C.
- a treatment solution (20% acetic anhydride / 80% ethanol solution
- a polylactic acid woven fabric-hyaluronic acid composite having a thickness of about 100 ⁇ m.
- a membrane (medical material) was obtained.
- the basis weight of the membrane portion (hyaluronic acid) of the obtained polylactic acid woven fabric-hyaluronic acid composite membrane was 40 g / m 2 , and the thread tension was 12.1 N / cm.
- Example 2 In place of the polylactic acid woven fabric, a polyglycolic acid non-woven fabric (trade name “Biofelt”, manufactured by Core Front Co., Ltd., 1 mm thick) was used in the same manner as in Example 1 described above except that a poly (polyethylene) nonwoven fabric having a thickness of about 1000 ⁇ m was used. A glycolic acid woven fabric-hyaluronic acid composite film (medical material) was obtained. The basis weight of the obtained polyglycolic acid woven fabric-hyaluronic acid composite membrane (hyaluronic acid) was 70 g / m 2 , and the thread tension was 19.5 N / cm.
- Example 3 50 mL of a 1% aqueous solution of sodium hyaluronate (molecular weight: 800,000 Da) was poured into a stainless tray having a length of 12 cm and a width of 10 cm and frozen in a ⁇ 80 ° C. freezer. The frozen product was freeze-dried (vacuum degree: ⁇ 20 Pa, shelf temperature: 25 ° C.) to obtain a sponge-like carrier composed of sodium hyaluronate. The obtained sponge-like carrier was immersed in a treatment solution (20% acetic anhydride / 80% ethanol solution) and allowed to stand at 50 ° C. for 1 hour for water insolubilization treatment to obtain a sponge-like carrier made of hyaluronic acid.
- a treatment solution (20% acetic anhydride / 80% ethanol solution
- the obtained sponge-like carrier was impregnated with 50 mL of a 1% sodium hyaluronate (molecular weight 800,000 Da) aqueous solution and then dried in a constant temperature bath at 20 ° C. to obtain a composite membrane of sponge-like carrier and sodium hyaluronate. .
- the obtained composite membrane is immersed in a treatment solution (20% acetic anhydride / 80% ethanol solution) and left to stand at 50 ° C. for 1 hour for water insolubilization treatment, and a sponge-like carrier-hyaluronic acid composite membrane having a thickness of about 120 ⁇ m. (Medical material) was obtained.
- the basis weight of the membrane portion (hyaluronic acid) of the obtained sponge-like carrier-hyaluronic acid composite membrane was 50 g / m 2 , and the thread tension was 10.5 N / cm.
- Example 4 Using a manual press machine, the sponge-like carrier comprising hyaluronic acid obtained in Example 3 was pressed at about 10 kgf to obtain a felt-like carrier. Then, in place of the sponge-like carrier made of hyaluronic acid, a felt-like carrier-hyaluronic acid composite having a thickness of about 90 ⁇ m was obtained in the same manner as in Example 3 except that the felt-like carrier obtained above was used. A membrane (medical material) was obtained. The basis weight of the film portion (hyaluronic acid) of the obtained felt-like carrier-hyaluronic acid composite membrane was 50 g / m 2 , and the thread tension was 13.4 N / cm.
- Example 5 The composite membrane produced in Example 1 was immersed in a 10% by volume glycerin aqueous solution, then air-dried and sealed in a sterilization bag. By irradiating 25 kGy of radiation and sterilizing the entire sterilization bag, an adhesion prevention film having a thickness of about 100 ⁇ m was obtained.
- An adult dog (beagle dog, female, 1.5 years old, weight about 10 kg) was opened after general anesthesia treatment, and the epidermis epidermis was peeled into 3 cm square. The abdomen was closed by placing an adhesion-preventing membrane so as to cover the peeled portion. Two weeks later, the dog was opened after general anesthesia, and no adhesions occurred.
- the medical material of the present invention is useful as a material for constituting an adhesion preventing material.
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Abstract
Description
[1]補強材と、前記補強材の少なくとも一部に侵入して前記補強材と一体化した膜部分とを備え、前記膜部分は、第1のポリアニオン性多糖類の水溶性塩を含有する原材料からなる膜前駆部分が、第1の酸無水物を含む処理液で水不溶化処理されて形成されており、前記補強材は、生体内分解・吸収性の高分子材料からなる不織布若しくは織布、又は第2のポリアニオン性多糖類の水溶性塩を含有する原材料からなる原料成形体が、第2の酸無水物を含む処理液で水不溶化処理されて形成されたスポンジ状担体若しくはフェルト状担体である医療用材料。
[2]前記膜部分の目付量が5~100g/m2である前記[1]に記載の医療用材料。
[3]糸掛張力が0.1~20N/cmである前記[1]又は[2]に記載の医療用材料。
[4]前記第1のポリアニオン性多糖類及び前記第2のポリアニオン性多糖類が、ヒアルロン酸、カルボキシメチルセルロース、及びアルギン酸からなる群より選択される少なくとも一種である前記[1]~[3]のいずれかに記載の医療用材料。
[5]前記第1の酸無水物及び前記第2の酸無水物が、それぞれ、無水酢酸及び無水プロピオン酸の少なくともいずれかである前記[1]~[4]のいずれかに記載の医療用材料。
[6]前記高分子材料が、ポリ乳酸、乳酸-カプロラクトン共重合体、及びポリグリコール酸からなる群より選択される少なくとも一種である前記[1]~[5]のいずれかに記載の医療用材料。
[7]前記[1]~[6]のいずれかに記載の医療用材料に多価アルコール又は多価アルコール水溶液が保持されてなる癒着防止材。
本発明の医療用材料は、補強材と、補強材の少なくとも一部に侵入して補強材と一体化した膜部分とを備える。膜部分は、膜前駆部分が所定の処理液で水不溶化処理されることで形成されている。そして、膜前駆部分は、第1のポリアニオン性多糖類の水溶性塩を含有する原材料によって形成されている。第1のポリアニオン性多糖類は、カルボキシ基やスルホン酸基等の負電荷を帯びた1以上のアニオン性基をその分子構造中に有する多糖類である。また、第1のポリアニオン性多糖類の水溶性塩は、第1のポリアニオン性多糖類中のアニオン性基の少なくとも一部が塩を形成したものである。なお、第1のポリアニオン性多糖類中のアニオン性基は、多糖類の分子中に導入されたものであってもよい。
本発明の癒着防止材は、前述の医療用材料に多価アルコール又は多価アルコール水溶液が保持されてなるものである。多価アルコールの具体例としては、エチレングルコール、ジエチレングリコール、ポリエチレングリコール、メチルグリセロール、ポリオキシエレングリコシド、マルチトール、マンニトール、キシリトール、ソルビトール、還元水飴、ジプロピレングリコール、ブチレングリコール、バリン、プロピレングリコール、グリセリン(グリセロール)、ポリグリセリン、グリセリン脂肪酸エステル等を挙げることができる。なかでも、グリセリン、キシリトール、ソルビトール、低分子ポリエチレングリコール等、医療分野や食品分野で使用されている多価アルコールが好適に用いられる。これらの好適に用いられる多価アルコールは、市場から入手してそのまま使用できる。グリセリン、ソルビトール等については、日本薬局方に適合したものを用いることが望ましい。グリセリンは、静脈への注射剤としても使用されるほど安全性の高い素材であるために特に好ましい。
植物原料由来のポリ乳酸織布(メッシュカウント97本/インチ、開口率62%、厚さ90μm)を縦12cm×横10cmの大きさに切断し、ステンレストレイに敷いた。1%ヒアルロン酸ナトリウム(分子量80万Da)水溶液30mLをトレイに流し込み、ポリ乳酸織布に染み込ませた後、20℃の恒温槽内で乾燥させて、ポリ乳酸織布-ヒアルロン酸ナトリウムの複合膜を得た。得られた複合膜を処理液(20%無水酢酸/80%エタノール溶液)に浸漬し、50℃で1時間放置して水不溶化処理して、厚さ約100μmのポリ乳酸織布-ヒアルロン酸複合膜(医療用材料)を得た。得られたポリ乳酸織布-ヒアルロン酸複合膜の膜部分(ヒアルロン酸)の目付量は40g/m2であり、糸掛張力は12.1N/cmであった。
ポリ乳酸織布に代えて、ポリグリコール酸不織布(商品名「Biofelt」、コアフロント社製、厚さ1mm)を用いたこと以外は、前述の実施例1と同様にして厚さ約1000μmのポリグリコール酸織布-ヒアルロン酸複合膜(医療用材料)を得た。得られたポリグリコール酸織布-ヒアルロン酸複合膜の膜部分(ヒアルロン酸)の目付量は70g/m2であり、糸掛張力は19.5N/cmであった。
1%ヒアルロン酸ナトリウム(分子量80万Da)水溶液50mLを縦12cm×横10cmのステンレストレイに流し込み、-80℃冷凍庫内で凍結させた。凍結したものを真空凍結乾燥(真空度-20Pa、棚温度25℃)し、ヒアルロン酸ナトリウムからなるスポンジ状担体を得た。得られたスポンジ状担体を処理液(20%無水酢酸/80%エタノール溶液)に浸漬し、50℃で1時間放置して水不溶化処理して、ヒアルロン酸からなるスポンジ状担体を得た。得られたスポンジ状担体に1%ヒアルロン酸ナトリウム(分子量80万Da)水溶液50mLを染み込ませた後、20℃の恒温槽内で乾燥させて、スポンジ状担体-ヒアルロン酸ナトリウムの複合膜を得た。得られた複合膜を処理液(20%無水酢酸/80%エタノール溶液)に浸漬し、50℃で1時間放置して水不溶化処理して、厚さ約120μmのスポンジ状担体-ヒアルロン酸複合膜(医療用材料)を得た。得られたスポンジ状担体-ヒアルロン酸複合膜の膜部分(ヒアルロン酸)の目付量は50g/m2であり、糸掛張力は10.5N/cmであった。
手動プレス機を使用して実施例3で得たヒアルロン酸からなるスポンジ状担体を約10kgfでプレスし、フェルト状担体を得た。そして、ヒアルロン酸からなるスポンジ状担体に代えて、上記で得られたフェルト状担体を用いたこと以外は、前述の実施例3と同様にして、厚さ約90μmのフェルト状担体-ヒアルロン酸複合膜(医療用材料)を得た。得られたフェルト状担体-ヒアルロン酸複合膜の膜部分(ヒアルロン酸)の目付量は50g/m2であり、糸掛張力は13.4N/cmであった。
各実施例で製造した複合膜を2cm角に切断し、直径3.5cm、深さ1.5cmの容器に入れ、PBS緩衝液(pH6.8)5mLを加えた。この容器を37℃に調整した振盪機に入れ、10~20rpmで振盪し、経時的な状態変化を目視観察した。その結果、いずれの複合膜についても、72時間後であっても膜の原形が保持されており、水不溶化されていることが分かった。また、72時間後の膨潤率(膨潤膜/乾燥膜(質量比))は2.3であった。
実施例1で製造した複合膜を、10体積%グリセリン水溶液に浸漬した後、風乾して滅菌用袋に封入した。25kGyの放射線を照射して滅菌用袋ごと滅菌して厚さ約100μmの癒着防止膜を得た。成犬(ビーグル犬、雌、1.5歳、体重約10kg)を全身麻酔処置後に開腹し、腹側壁表皮を3cm角に剥離した。剥離部分を覆うように癒着防止膜を配置して閉腹した。2週間後、同犬を全身麻酔処置後に開腹したところ、癒着は発生していなかった。また、犬の体内に配置(埋植)した癒着防止膜は、埋植後2週間で消失していた。これは、生体内のナトリウムイオン等によって癒着防止膜を構成するヒアルロン酸のカルボキシ基が徐々に中和され、可溶性のヒアルロン酸塩に変化して溶解し、生体内に吸収されたものと推測される。これに対して、癒着防止膜を配置することなく閉腹した犬については、剥離部分と腸に癒着が生じていることが観察された。また、上記の癒着防止膜に代えてポリ乳酸織布のみを配置して閉腹した犬についても、剥離部分と腸に癒着が生じていることが観察された。
Claims (7)
- 補強材と、前記補強材の少なくとも一部に侵入して前記補強材と一体化した膜部分とを備え、
前記膜部分は、第1のポリアニオン性多糖類の水溶性塩を含有する原材料からなる膜前駆部分が、第1の酸無水物を含む処理液で水不溶化処理されて形成されており、
前記補強材は、生体内分解・吸収性の高分子材料からなる不織布若しくは織布、又は第2のポリアニオン性多糖類の水溶性塩を含有する原材料からなる原料成形体が、第2の酸無水物を含む処理液で水不溶化処理されて形成されたスポンジ状担体若しくはフェルト状担体である医療用材料。 - 前記膜部分の目付量が5~100g/m2である請求項1に記載の医療用材料。
- 糸掛張力が0.1~20N/cmである請求項1又は2に記載の医療用材料。
- 前記第1のポリアニオン性多糖類及び前記第2のポリアニオン性多糖類が、ヒアルロン酸、カルボキシメチルセルロース、及びアルギン酸からなる群より選択される少なくとも一種である請求項1~3のいずれか一項に記載の医療用材料。
- 前記第1の酸無水物及び前記第2の酸無水物が、それぞれ、無水酢酸及び無水プロピオン酸の少なくともいずれかである請求項1~4のいずれか一項に記載の医療用材料。
- 前記高分子材料が、ポリ乳酸、乳酸-カプロラクトン共重合体、及びポリグリコール酸からなる群より選択される少なくとも一種である請求項1~5のいずれか一項に記載の医療用材料。
- 請求項1~6のいずれか一項に記載の医療用材料に多価アルコール又は多価アルコール水溶液が保持されてなる癒着防止材。
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| EP16755628.1A EP3263141A4 (en) | 2015-02-27 | 2016-02-25 | Medical material and anti-adhesion material |
| CN201680011291.1A CN107249651A (zh) | 2015-02-27 | 2016-02-25 | 医疗用材料和防粘连材料 |
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| WO2019082922A1 (ja) * | 2017-10-27 | 2019-05-02 | 大日精化工業株式会社 | 化粧料用成形物及びその製造方法 |
| WO2021201150A1 (ja) | 2020-03-31 | 2021-10-07 | 株式会社クレハ | 生体吸収性医療材料 |
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| CN116492497A (zh) * | 2023-05-09 | 2023-07-28 | 温学辉 | 一种抗创面粘连、抗碳屑脱落的活性碳纤维组织物结构 |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH07309902A (ja) * | 1994-05-16 | 1995-11-28 | Seikagaku Kogyo Co Ltd | アシル化ヒアルロン酸の製造法 |
| JPH08208706A (ja) * | 1994-10-06 | 1996-08-13 | Genzyme Corp | ポリアニオン性多糖類と疎水性生物吸収ポリマーを含む組成物 |
| JPH08253504A (ja) * | 1994-12-22 | 1996-10-01 | Hercules Inc | 架橋された酸性多糖類及びそれらの用途 |
| WO2013018759A1 (ja) * | 2011-08-02 | 2013-02-07 | 大日精化工業株式会社 | 癒着防止用医用材料及びその製造方法 |
Family Cites Families (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6610669B1 (en) * | 1987-09-18 | 2003-08-26 | Genzyme Corporation | Water insoluble derivatives of polyanionic polysaccharides |
| US4959341A (en) * | 1989-03-09 | 1990-09-25 | Micro Vesicular Systems, Inc. | Biodegradable superabsorbing sponge |
| IT1263316B (it) * | 1993-02-12 | 1996-08-05 | Fidia Advanced Biopolymers Srl | Tessuto non tessuto multistrato in cui uno degli strati e' costituito essenzialmente da esteri dell'acido ialuronico |
| EP1005874B1 (en) * | 1997-08-22 | 2005-05-18 | Denki Kagaku Kogyo Kabushiki Kaisha | Hyaluronic acid gel, process for producing the same and medical material containing the same |
| JP2000191802A (ja) * | 1998-10-21 | 2000-07-11 | Daicel Chem Ind Ltd | フィルム及びその製造方法 |
| DE60018814T2 (de) * | 1999-01-21 | 2006-04-06 | Nipro Corp. | Nähbare Membran zur Adhäsionsverhinderung |
| EP1174463A4 (en) * | 1999-02-19 | 2008-04-16 | Denki Kagaku Kogyo Kk | GEL FROM HYALURONIC ACID, METHOD FOR THE PRODUCTION THEREOF, AND THIS CONTAINING MEDICINE MATERIAL |
| GB9925379D0 (en) * | 1999-10-28 | 1999-12-29 | Tissuemed Ltd | Medical use |
| JP2005239687A (ja) * | 2004-02-27 | 2005-09-08 | Nobuhiko Yui | 嚢胞内投与薬 |
| KR101333245B1 (ko) * | 2005-01-28 | 2013-11-26 | 네오케미아 가부시키가이샤 | 이산화탄소 외용제 제조용 조성물 |
| JP5721379B2 (ja) * | 2010-09-21 | 2015-05-20 | 学校法人同志社 | 親水性高分子を含む自動縫合器用縫合補強材 |
-
2016
- 2016-02-25 CN CN201680011291.1A patent/CN107249651A/zh active Pending
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Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH07309902A (ja) * | 1994-05-16 | 1995-11-28 | Seikagaku Kogyo Co Ltd | アシル化ヒアルロン酸の製造法 |
| JPH08208706A (ja) * | 1994-10-06 | 1996-08-13 | Genzyme Corp | ポリアニオン性多糖類と疎水性生物吸収ポリマーを含む組成物 |
| JPH08253504A (ja) * | 1994-12-22 | 1996-10-01 | Hercules Inc | 架橋された酸性多糖類及びそれらの用途 |
| WO2013018759A1 (ja) * | 2011-08-02 | 2013-02-07 | 大日精化工業株式会社 | 癒着防止用医用材料及びその製造方法 |
Non-Patent Citations (1)
| Title |
|---|
| See also references of EP3263141A4 * |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2019082922A1 (ja) * | 2017-10-27 | 2019-05-02 | 大日精化工業株式会社 | 化粧料用成形物及びその製造方法 |
| JP2019077665A (ja) * | 2017-10-27 | 2019-05-23 | 大日精化工業株式会社 | 化粧料用成形物及びその製造方法 |
| US11458088B2 (en) | 2017-10-27 | 2022-10-04 | Dainichiseika Color & Chemicals Mfg. Co., Ltd. | Cosmetic molded article and method for manufacturing same |
| WO2021201150A1 (ja) | 2020-03-31 | 2021-10-07 | 株式会社クレハ | 生体吸収性医療材料 |
| JP2024001354A (ja) * | 2020-03-31 | 2024-01-09 | 株式会社クレハ | 生体吸収性医療材料 |
| JP7689344B2 (ja) | 2020-03-31 | 2025-06-06 | 株式会社クレハ | 生体吸収性医療材料 |
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