JPH03109076A - Surgical adhesive sheet - Google Patents

Abstract

PURPOSE:To improve handling characteristics by coating the surface of a sheet with a surgical adhesive made of a urethane prepolymer. CONSTITUTION:The title sheet is a sheet prepd. by coating the surface of a sheet with a surgical adhesive made of a urethane prepolymer. As a sheet used, a non-absorptive sheet and a bioabsorptive sheet are cited and as the non-absorptive sheet, a sheet of a polymn. type polymer such as a polyethylene, an ethylene copolymer and a polypropylene and a condensation type polymer such as a polyester and a polycarbonate can be cited. As the bioabsorptive sheet, a sheet made of a natural or a synthetic polymer can be cited. In addition, as the surgical adhesive, an NCO-terminated hydrophilic urethane prepolymer made of a polyisocyanate and a hydrophilic polyether polyol, a fluorinated NCO-terminated hydrophilic urethane prepolymer made of a fluorinated polyisocyanate and a hydrophilic polyether polyol and a urethane prepolymer obtd. by reacting various polyisocyanate with polyols and polyamines can be cited.

Description

[Detailed description of the invention] [Industrial application field] The present invention relates to surgical adhesive sheets.

[Prior Art] Hydrophilic urethane prepolymers obtained by the reaction of polyisocyanate and polyether polyol are conventionally known as surgical adhesives (for example, Japanese Patent Laid-Open No. 1982-1999).
14861iG).

[Problems to be Solved by the Invention] Conventional urethane prepolymer surgical adhesives have high viscosity and high adhesive strength, making them difficult to handle and making it difficult to use them where and in the required amount. Furthermore, use of more adhesive than necessary causes bonding with other living tissues, causing problems other than those intended for treatment. Furthermore, since urethane prepolymers react with water and body fluids on the surface of living tissues and rapidly harden, there are restrictions such as the need to use surgical adhesives quickly.

As described above, conventional surgical adhesives have had many problems with ease of handling during surgical operations.

[Means for Solving the Problems] In view of the above-mentioned problems, the present inventors conducted extensive studies to find a surgical adhesive with improved handling properties, and as a result, they arrived at the present invention. That is, the present invention is a surgical adhesive sheet characterized in that the surface of the sheet is coated with a urethane prepolymer surgical adhesive.

Examples of the sheet used in the surgical adhesive sheet of the present invention include non-absorbable sheets and bioabsorbable sheets.

Non-absorbent sheets include polyethylene, ethylene copolymer, polypropylene, polybutene, (meth)acrylic resin, vinyl chloride resin, polyvinylidene chloride, polyvinyl alcohol, fluorine resin, hydrochloric acid rubber, butanoene polymer, chloroprene polymer. Examples include sheets obtained from condensation type polymers such as polyester, polycarbonate, nylon, polyimide, polyurethane resin, and silicone resin.

As a bioabsorbable sheet, Tokuhyo Sho GO-500419
Examples include sheets obtained from natural and synthetic polymers described in Publication No. 5. Bioabsorbable natural polymers include partially oxidized cellulose, chitin and its derivatives, collagen and its derivatives, and the like. Bioabsorbable synthetic polymers include polyamino acids, polyamino acid copolymers and their derivatives, polylactic acid, polyglycolic acid, copolymers of lactic acid and glycolic acid, polyhydroxybutyrate, hydroxybutyrate, and hydroxybutyrate. Examples include copolymers and the like.

The above polymers used in the sheet of the present invention may be used alone or in a mixture of two or more.

Preferred among these are non-absorbable polyurethane resins, silicone resins, fluororesins; and bioabsorbable polyamino acids, polyamino acid copolymers and their derivatives, polyglycolic acid, copolymers of lactic acid and glycolic acid. This is a sheet obtained from

Examples of the shape of the sheet of the present invention include a continuous film, a perforated film, and a porous nonwoven fabric.

Although the thickness of the sheet of the present invention is closely related to the shape, it is usually in the range of 5 μm to IO+gm. The shape and thickness of this sheet can be combined in different ways depending on the site where it is used, how it is used, and its purpose.

In addition, when using a perforated film or a porous nonwoven fabric as the sheet of the present invention, a film (silicone resin film, polyurethane resin film, etc.) can be laminated on the surface.

The surgical adhesive used in the present invention includes:
Polyisocyanates (tolylene diisocyanate (TDI),
diphenylmethane diisocyanate (MDI), p-phenylene diisocyanate (PPDI), aromatic polyisocyanate, aliphatic polyisocyanate, alicyclic polyisocyanate, etc.) and hydrophilic polyether polyols (compounds containing at least two active hydrogen atoms) NGO-terminated hydrophilic urethane prepolymers of (ethylene glycol, propylene glycol, etc.) and adducts of ethylene oxide and, if necessary, other alkylene oxides) Fluorine-containing polyisocyanates described in Japanese Patent Application No. 83-52918 ( General formula: OCN・R”・NCO and
General formula: OCN Co1t Rt CHa・NCO
(However, R is a perfluoroalkylene group having 1 to 20 carbon atoms, including those containing one or more ether bonds, etc.) and hydrophilic polyether polyols (having at least two active hydrogen atoms). Fluorine-containing NGO-terminated hydrophilic urethane prepolymer of compound (ethylene glycol, propylene glycol, etc.) and adduct with ethylene oxide and, if necessary, other alkylene oxide Examples include urethane prepolymers obtained by reacting various polyisocyanates with polyols and polyamines, as described in (Publishing, 1987). Among these urethane prepolymers, preferred is a fluorine-containing NGO-terminated hydrophilic urethane prepolymer.

Surgical adhesives may contain physiologically active drugs (central nervous system drugs, allergy drugs, circulatory organ drugs,
drugs for respiratory organs, drugs for digestive organs, hormones, metabolic drugs, antineoplastic agents, antibiotic preparations, chemotherapy drugs, etc.), fillers (e.g. carbon black, red iron, calcium silicate, sodium silicate, oxidation titanium, acrylic resin powder, various ceramic powders, etc.), softeners [e.g.
Dibutyl phthalate (DBP), dibutyl phthalate (DOP), tricresyl phosphate (TCP)
, ) ribtoxyethyl phosphate, various other esters, etc.], stabilizers (for example, trimethyldihydroquinone, phenyl-β-naphthylamine, p-impropoxydiphenylamine, diphenyl-p-phenylenediamine, etc.), etc. can be blended. The amount of these ingredients is
It is usually 0 to 20% by weight, preferably 0 to 5% by weight, based on the surgical adhesive.

The amount of surgical adhesive to be used for the surgical adhesive sheet of the present invention varies depending on the intended use site and purpose, but is usually 110-1000 (I/■2, preferably 10
0 to 5000 g/+''.

The surgical adhesive sheet of the present invention can be produced by directly coating the sheet with adhesive, by coating adhesive once on release paper and then transferring it to the sheet, by coating adhesive continuously or discontinuously, This can be carried out by a manufacturing method commonly used for manufacturing adhesive tapes, such as covering the surface coated with the adhesive with ψ1 release paper or the like. Additionally, during manufacturing, in order to reduce the viscosity of the surgical adhesive, non-reactive organic solvents (methyl ethyl ketone, acetone, toluene,
Coating may be carried out by diluting with xylene, ethyl acetate, dimethylformamide, etc.). The above method for manufacturing surgical adhesive sheets is the same for both non-absorbable and bioabsorbable sheets.

The method of using the surgical adhesive sheet of the present invention in medical practice varies depending on the site and purpose of use. ■Transfer method: Paste the surgical adhesive sheet on the affected area and apply the surgical adhesive. A method of transferring it to the affected area.For example, when a parenchymal organ is cut with a scalpel or the like, a large amount of bleeding occurs from the cut surface.

In order to control this bleeding, it is necessary to perform a hemostasis operation using this surgical adhesive sheet, but in this case, apply the surgical adhesive sheet to the entire affected area, apply pressure to stop the bleeding, and transfer the surgical adhesive to the affected area. to stop the bleeding. The sheet used for the surgical adhesive sheet is preferably a film made of silicone resin or fluororesin, which does not adhere to the surgical adhesive, in order to ensure smooth transfer. ■Reinforcement method: A method of attaching a composite material that combines a sheet and surgical adhesive to areas in the body that are subject to strong forces or areas that have defects. When used in vivo, it is preferable to use a bioabsorbable sheet. ■Wound protection method 2. A method of applying surgical adhesive sheets to wounds such as burns to prevent external forces and infection and promote healing.

The shape of the sheet is desirably a material and shape that is permeable to water vapor and air, and includes not only a continuous sheet but also a perforated sheet, a non-woven sheet, and the like. It can also be used for other applications such as skin closure.

In the surgical adhesive sheet of the present invention, the surgical adhesive coated on the surface polymerizes due to the presence of a small amount of moisture, such as moisture in the material or moisture in the air, reducing adhesive strength. Therefore, it is necessary to use anhydrous not only the main component but also the sheet and other compounding agents, and it is preferable to keep moisture-containing air out during manufacturing. The obtained surgical adhesive sheet can be stored for a long period of time by storing it in a container that can block air and moisture, for example.

[Examples] The present invention will be further explained below with reference to Examples and Comparative Examples, but the present invention is not limited thereto. In the following, EO is ethylene oxide, PO is propylene oxide, and PTMG is polytetramethylene glycol. Urethane prepolymer is made by mixing and stirring polyisocyanates and polyether polyol watered under reduced pressure.
It was obtained by reacting at a temperature of 0°C for 8 hours.

% and parts in Examples and Comparative Examples refer to 1% and parts by weight. The surgical adhesives used in Examples and Comparative Examples are as follows.

(1) Surgical adhesive A1: 0CN-〇H* (CF2)acH*・! Consists of urethane prepolymer (NCO content 2.5%) obtained by reacting lCO with polyether polyol (EO/PO random copolymer, average molecular weight 3.000, oxyethylene content 80%). Surgical adhesive.

(2) Surgical adhesive A2: 0CFI 11CH* (CFa LCHt/NCO and polyether polyol (EO/PO random copolymer, average molecular weight 4.000, oxyethylene content [fi80
Urethane prepolymer (NG
A surgical adhesive consisting of an O content of 3.4%.

(3) Surgical adhesive A3: PPDI (P-phenylene diisocyanate) and polyether polyol (PTMG/EO block copolymer,
Average molecular weight 2,000, oxyethylene content 50%
), obtained by reacting urethane prepolymer (NGO
Surgical adhesive consisting of a content of 5.19A).

Example 1 A fluororesin sheet (thickness: 1.5 mm) was coated with surgical adhesive A+ (coating amount: 400 g/a+) to obtain a surgical adhesive sheet.

The adult dog's liver parenchyma was placed with forceps following a predetermined cutting line spanning approximately 20 mm of length, and the liver parenchyma was then excised along the medial side of the forceps. The entire cut surface was pressed with the surgical adhesive sheet described above, and after about 5 minutes, the fluororesin film was removed and the adhesive was transferred to the affected area. The entire cut surface should be completely sealed with adhesive and hemostasis should be complete. Moreover, it was very easy to handle.

Example 2 A nonwoven sheet (thickness: approximately 5 mm) composed of a copolymer of lactic acid and glycolic acid was coated with surgical adhesive A2 (coating amount: 30 parts g/i'') 1. Surgical adhesive A drug sheet was obtained.

The lung parenchyma of an adult dog was placed with forceps along the assumed cutting line over a length of about 20 cm, and the lung parenchyma was then excised along the inside of the forceps. After applying pressure to the entire cut surface for about 5 minutes to stop the bleeding using the surgical adhesive sheet, the forceps were removed. The cut surface and the surgical adhesive sheet were integrated, and hemostasis should have been completed. Moreover, it was very easy to handle.

Example 3 10 parts of surgical adhesive A3 was dissolved in 10 parts of ethyl acetate to reduce the viscosity, and the solution was coated on a polyurethane film (thickness = 30 μm) to obtain a surgical adhesive sheet.

A surgical adhesive sheet was used to join the incision on the rabbit's back.

The wound edges were brought close to each other and the above adhesive sheet was applied. After 8 weeks, the affected area had healed well, with almost no scar left from the incision. Moreover, it was very easy to handle.

Example 4 A non-woven sheet (thickness = 30μ) composed of polygelcolic acid was coated with surgical adhesive A (coating amount: IQOg/+* and silver sulfadiazine was applied to the surface as an antibacterial agent). A surgical adhesive sheet was obtained.

A mouse skin defect (1 cm x lc) was surgically created, and after inoculating with Pseudomonas aeruginosa, the above adhesive sheet was attached. After one week, the urethane film was removed. After 8 weeks, the affected area was well healed and no damage due to infection was observed. Moreover, it was very easy to handle.

Comparative Example 1 The liver parenchyma of an adult dog was placed with forceps along an assumed cutting line over a length of about 2 cm, and then the liver parenchyma was excised along the inner side of the forceps. Apply surgical adhesive A to this entire cut surface.
+ was applied with a spatula, and the forceps were removed after about 5 minutes. When applying the surgical adhesive A1, the prepolymer also adhered to other organs such as the stomach due to its high viscosity.

Furthermore, when the forceps were removed, the adhesive that had been attached to the forceps was pulled, causing some of the seal around the periphery to peel off, causing rebleeding.

Comparative Example 2 The carotid artery of an adult dog was temporarily stopped from bleeding with forceps, and an incision of approximately 5+*w was made. Surgical adhesive A3 was applied to the area around the cut. Adhesive performance was good and no bleeding was observed, but the high viscosity made it difficult to handle, and the surgical adhesive adhered to areas other than where it was needed, causing blood vessels to join with other organs.

[Effects of the Invention] The surgical adhesive sheet of the present invention allows the surgical adhesive to be used in the required place as much as necessary by cutting the sheet, and is much easier to handle than conventional surgical adhesives. I was able to improve my sexuality. In medical practice, this method does not require any special equipment or skills, and has shown great effects in reducing surgical time and reliability. Furthermore, surgical adhesive sheets do not use adhesives alone, but are combined with sheets, so
Not just as a bonding material, but also for batch processing of defective parts, etc.
It has also become possible to apply the technique as a reinforcing material for living organisms.

The application of the adhesive sheet of the present invention to surgery makes it possible to use a suturing technique called adhesion in addition to the conventional suturing technique, which can prevent bleeding, prevent leakage of enzymes from the digestive organs, etc., and minimize blood vessels. Significant improvements in medical technology have been seen, including the avoidance of stenosis accidents, nerve attachment, temporary fixation prior to suturing, and reliability through the combined use of sutures and adhesives. Also,
It has the effect of imparting high reliability and high performance not only in surgery but also in all areas of medical care, such as bonding wounds and cuts, adhesive treatment in dentistry, and treatment by gradually releasing drugs in combination with physiologically active drugs. Be looked at.

Claims (1)

[Claims] 1. A surgical adhesive sheet, characterized in that the surface of the sheet is coated with a urethane prepolymer surgical adhesive. 2. The surgical adhesive sheet according to claim 1, wherein the sheet is a non-absorbable sheet made of a polymer selected from the group consisting of polyurethane resin, silicone resin and fluororesin. 3. Claim 1, wherein the sheet is a bioabsorbable sheet obtained from a polymer selected from the group consisting of polyamino acids, polyamino acid copolymers and derivatives thereof, polyglycolic acid, copolymers of lactic acid and glycolic acid. Surgical adhesive sheet as described.