Functional surfaces of medical devices based on laser processing: a review
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摘要: 制备功能性表面是提升医疗器械治疗性能和安全性的重要方法之一。当前,基于激光加工的功能性表面微纳结构制造技术在优化医疗器械表面性能方面应用广泛。综述了医疗植入器械和手术器械表面激光加工功能性微纳结构在细胞功能调控、抗菌性、耐蚀性、摩擦特性、抗黏附性等方面的研究现状,剖析了当前医疗器械功能性表面激光加工的优势和局限,展望了医疗器械功能性表面激光加工技术的发展前景。Abstract: The preparation of functional surfaces is one of the important methods to enhance the therapeutic performance and safety of medical devices. Currently, the fabrication of functional surface microstructures based on laser processing is widely used in the optimizing medical device surface properties. This paper reviews the current research status of functional microstructures for laser processing of medical implantable and surgical devices in terms of cell function regulation, antimicrobial properties, corrosion resistance, frictional properties, and anti-adhesion, etc. It analyzes the advantages and limitations of laser processing of functional surfaces for medical devices and outlines the development prospects of laser processing technology for functional surfaces for medical devices.
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表 1 部分医疗植入器械和手术器械的分类与所需功能
Table 1. Classification and required functions of some medical implants and surgical instruments
分类 器械 应用 所需功能 植入器械 接骨板 + 骨螺钉 连接固定,维持骨头的位置 高耐磨性;促进骨细胞生长 人工骨 替代人体骨协助修复骨组织缺损 具有良好的生物相容性;促进骨组织、细胞生长和黏附 血管支架 支撑狭窄闭塞段血管,保持管腔血流通畅 表面具有良好的减阻、抗黏附作用,防止发生再狭窄 手术器械 手术刀 用于切开皮肤和肌肉 切割时形成低摩擦,减少阻力保证切口平整 手术钳、血管夹 夹持韧致密组织、离断的组织残端 形成稳定的夹持,具有强大的湿摩擦能力防止滑脱 高频电刀 实现对肌体组织的分离和凝固,起到切割和
止血的目的具有优秀的抗黏附性,减少因表面高温黏附的
生物组织表 2 激光加工医疗器械功能性表面的研究现状
Table 2. Research status of laser processing of functional surfaces of medical devices
器械类别 材料 激光参数 结构参数 主要结论 文献 性能 波长 脉宽 形状 尺寸 植入器械 骨科植入物 Ti6Al4V — — 微槽 宽度10,30 μm
深度10 μm微槽表面呈亲水性,表面粗糙度增加,成骨细胞增殖和分化能力提高 [22] 细胞功能
调控骨科植入物 Ti6Al4V 800 nm 120 fs 微坑 + 纳米波纹 微坑深度800 nm,
直径30 μm
纳米波纹深度约200 nm微坑与纳米波纹的结合提高了成骨细胞的分化能力 [23] 牙科、骨
科植入物Ti6Al4V 1070 nm 500 μs 仿生六边形 边长150~300 μm 提高表面亲水性,能够促进成骨细胞的黏附和增殖 [24] 骨科植入物 氧化铝增韧氧化锆陶瓷 1030 nm 560 fs 微槽 + 纳米波纹 微槽宽度10 μm
纳米波纹周期300~400 nm细胞黏着面积、增殖数增加,表面结构可以调节细胞的排列和引导增殖 [26] 牙科、骨科
植入物钛合金板(TA2) 1030 nm 500 fs LIPSS、纳米柱 周期(710 ± 60)nm、(750 ±
130)nm结构表面细菌覆盖率远小于光滑表面,抑制细菌生物膜的形成 [34] 抗菌性 植入物 AISI 316L 1030 nm 8 ps 周期性亚微米
结构周期850 nm
深度500 nm大肠杆菌黏附率降低了99.8%,金黄色葡萄球菌降低了70.6% [35] 种植体 Ti6Al4V 1064 nm — 微坑 深度3 μm
直径20 μm结构表面形成氧化钛结晶层,金黄色葡萄球菌的黏附率降低约85%。 [36] 植入器械 牙科、骨科植入物 Zr非晶合金 1030 nm 300 fs LIPSS、SWPSS、微孔结构 LIPSS周期830 nm
SWPSS周期 2950 nm
微孔结构周期10.24 µm、直径2.5 µm3种结构均有抑菌效果,SWPSS最好,结构尺寸略小于细菌时,抑制效果最优 [38] 植入物 AISI 316L 1064 nm 104 ns 微坑、微槽 深度3.7~6.2 µm 深度最大的微坑减少98%的细菌黏附,结构深度对细菌黏附行为有显著影响 [40] 牙科种植体 3Y-TZP氧化锆陶瓷 355 nm — 仿生蜂窝结构 边长200 µm
间距50 µm结构表面呈现疏水性,金黄色葡萄球菌约30% [41] 植入物 AISI 304L 1064 nm 100 ns 波纹状 — 提高耐蚀性和抗菌性,腐蚀过后结构表面有凹坑形成 [47] 耐蚀性 植入物 AISI 316L 355 nm 15 ns 微裂纹 — 激光改性后的表面耐蚀性提高了98.61% [48] 血管支架 AISI 316L 1064 nm 10 ps LIPSS 周期220 nm LIPSS减少了接触面积,耐腐蚀性比无结构表面提高约50倍 [50] 骨螺钉 Ti6Al4V 1064 nm 100 ns 微凸起环、
微光滑环、
微重叠环直径50 µm
深度5 µm耐蚀性分别提高97.02%、96.11%和97.97% [51] 手术器械 医用穿刺针 AISI 304L 532 nm 8 ps 微槽 槽宽50 µm
间距200 µm结构能减少接触面积,减摩效果超过80% [59] 摩擦特性 手术刀 AISI 316L 1053 nm 12 ns 微槽 槽宽100~500 µm
槽深5~15 µm切割时摩擦力降低33.2%,微织构表面切口更加平整 [62] 手术刀 AISI 316L 532 nm 8 ps 微凹坑 直径110 μm
深度30 μm
间距250 μm切割组织时摩擦力降低48% [63] 血管夹 Ti6Al4V 355 nm — 微槽、微坑 直径30~54 µm
间距40~100 µm
槽宽30~50 µm微槽宽度30 µm、间距40 µm的摩擦系数最高,摩擦力与接触面积成正比 [64] 电刀 AISI 316L 1070 nm 500 µs 仿生鳞片 高度0.5 µm 切割过程中,摩擦系数降低约15% [65] 电刀 AISI 304 532 nm 10 ps 微坑、微槽 微坑直径50 µm
槽宽25~100 µm
深度12 µm横向微槽的抗黏附效果最好,面积密度增加,黏附量减小 [72] 抗黏附性 电刀 AISI 304 1030 nm 300 fs 仿生六边形 内接圆直径20 μm 结构间距40 μm 加工深度6 μm 仿生结构的黏附力与其疏水性呈正相关,平均组织黏附量减少约36%。 [75] 手术刀 AISI 316L 1064 nm 100 ns 微凸圆 直径30~90 µm
间距30~90 µm结构表面呈疏水性,对血清溶液具有强大抗黏附效果 [76] 手术刀 AISI 316L 1064 nm 100 ns 激光烧蚀多孔 宽度4~6 μm
长度10~15 μm结构表面可以减少血清的黏附量,其性能与疏水性呈正相关 [77] -
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