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Using Nanotechnology to Improve Soft Tissue Adhesion to Intraosseous Transcutaneous Amputation Prostheses (ITAP)

Giusto, Elena; (2019) Using Nanotechnology to Improve Soft Tissue Adhesion to Intraosseous Transcutaneous Amputation Prostheses (ITAP). Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Intraosseous Transcutaneous Amputation Prosthesis (ITAP) is a new generation device in limb replacement that may solve the issues of the externally fixed stump socket prosthesis, helping to restore the original limb function. ITAP is implanted into the medullary cavity of bone with an abutment that protrudes through the skin for limb attachment. The skin-implant interface is maintained with a flange, which resides below the epithelium, and is designed with pores to enhance soft tissue sub-epithelial ingrowth. This goals of this design are to stabilises the soft tissue, reducing the relative movements and seals the skin ITAP interface preventing bacterial infection. The current ITAP design includes a bi-dimensional flange that results in poor soft tissue attachment and, consequently, in the failure of the implant. My thesis aims to investigate firstly the effect of a new three dimensional porous flange on soft tissue attachment and ingrowth both in-vivo and in a clinical study with animal patients. Secondly, to improve epithelial and sub-epithelial attachment to the flange in-vitro and ex-vivo by modifying the surface of the ITAP with TiO2 nanotubes which have been shown to enhance cell attachment and have the potential to prevent downgrowth and infection around ITAP. The key original contributions to knowledge from my thesis are that firstly porous flanges increase the soft tissue attachment and ingrowth, contributing to stabilize the implant (p-value = 0.01 comparing 1000µm and 1250µm porosity with smooth titanium).. Moreover the size of nanotubes around 110nm, significantly increase the epithelial and sub-epithelial tissue attachment compared to the currently used smooth titanium, in- vivo, in vitro and ex-vivo, in order to create a stronger bound on the interface with the ITAP. In conclusion the combination of the porosity of the flange and the TiO2 nanotubes can significantly increase the soft tissue attachment and ingrowth to the flange in comparison with the commercially used bi-dimensional and smooth ITAPs.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Using Nanotechnology to Improve Soft Tissue Adhesion to Intraosseous Transcutaneous Amputation Prostheses (ITAP)
Event: University College London
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10087923
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