BIOMATERIALS

Biomedical Engineering
Sem-III

Prof. Arunkumar Ram

Module 9: Biomaterials for

Soft Tissue Replacement

Semester: III

INTRODUCTION
On what factors does success of biomaterials

Biomaterials

Module 9

depends?

Prof. Arunkumar Ram

1.
2.

Materials used

Design considerations

Dept. of Biomedical Engg.

Semester: III

INTRODUCTION
The success of soft

Module 9

tissue implant has

been primarily
because of
development of

Biomaterials

synthetic polymers.

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Semester: III

INTRODUCTION
Why success of soft tissue is on polymers?

Biomaterials

Module 9

Polymers can be tailor made to match the

properties of soft tissues.

Made into various physical forms

Liquids for space fillings

Fibers for sutures materials

Films for catheter balloons

Knitted fabrics for blood vessels

Solid forms for weight bearing applications

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Why success of soft tissue is on polymers?

Biomaterials

Module 9

Semester: III

INTRODUCTION

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Why success of soft tissue is on polymers?

Biomaterials

Module 9

Semester: III

INTRODUCTION

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Why success of soft tissue is on polymers?

Biomaterials

Module 9

Semester: III

INTRODUCTION

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Semester: III

INTRODUCTION
Minimal requirement for a soft tissue implant

Biomaterials

Module 9

They should achieve a close approximation of

physical properties especially flexibility and texture.

They should not deteriorate or change properties

after implantation with time.

They should not cause adverse tissue reaction.

They should be non carcinogenic, nontoxic, non

allergenic, non immunogenic.

They should be sterilizable.

They should be low cost

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Semester: III
Module 9

SUTURES, SURGICAL TAPES AND

ADHESIVES
Two kinds of sutures

Biomaterials

Absorbable

Non Absorbable

Also classified on the basis of their origin

Natural Sutures (catgut, silk and cotton)

Synthetic Sutures (nylon, polyethylene, polypropylene

Also classified on their physical form

Monofilament

Multifilament

Prof. Arunkumar Ram

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
The absorbable suture catgut made up of collagen derived

Module 9

from sheep intestinal submucosa.

Treated with chromic salt (chromium salt) to increase its

strength and is cross linked.

Biomaterials

This treatment extends the life of catgut suture by 3-7

days upto 20-40 days

Prof. Arunkumar Ram

10

Dept. of Biomedical Engg.

Semester: III
Module 9

SUTURES, SURGICAL TAPES AND

ADHESIVES
It is very interesting to know.

Stress concentration at a surgical knot

decreases the suture strength of catgut by half,
no matter what kind of knotting technique you

Biomaterials

use.

Prof. Arunkumar Ram

11

Dept. of Biomedical Engg.

Most effective knotting technique is the square knot

technique with three ties to prevent loosening.

Module 9

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES

Biomaterials

But one of the studies reveal that whether you make loose
knot or tight knot, there is no measureable difference in
the wound healing
But recommended to have loose suturing, it lessens pains
and reduces cutting soft tissues.

Prof. Arunkumar Ram

12

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
Catgut and other absorbable sutures (PGA, PLA) invokes

Module 9

tissue reactions although the effect diminishes as they are

being absorbed.
Silk and cotton show more reaction as compared to synthetic

Biomaterials

sutures like polyester, nylon, polyacronitrile.

Prof. Arunkumar Ram

13

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
Risk of Infection

Module 9

If suture is contaminated, risk of infection may increase

many folds.

Polypropylene,

nylon,

PGA

sutures

developed

lesser

degrees of infection than sutures made from chromic

catgut and polyester.
The cause of infection is micro organism not biomaterial

Biomaterials

Prof. Arunkumar Ram

14

Dept. of Biomedical Engg.

Surgical Tapes and Staples

Biomaterials

Module 9

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES

Prof. Arunkumar Ram

15

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
Surgical Tapes and Staples

1.

Avoid pressure necrosis (death of body cells/tissues)

2.

Scar tissue formations

3.

Problem of stitch abscesses (collection of pus)

4.

Problems of Weakened Tissues

Biomaterials

Module 9

Why are surgical tapes used?

Prof. Arunkumar Ram

16

Dept. of Biomedical Engg.

Semester: III
Module 9

SUTURES, SURGICAL TAPES AND

ADHESIVES
Problem with Surgical Tapes/Band aids
1.

Misaligned Wound edges

2.

Poor adhesion caused by moisture, dirt.

3.

Wound drainage

4.

Late separation of tapes etc

Biomaterials

Applications

Assembling scraps of donor skin for skin graft.

Correcting nerve tissues for neural growth, etc

Prof. Arunkumar Ram

17

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
STAPLES

Biomaterials

Module 9

Staples made up of metals (Ta, Stainless steel, TI-Ni Alloy)

can be used for closure of large surgical incision
In procedures like

Cesrean section

Intestinal surgery

Surgery for bone fracture

Tissue response is similar to synthetic sutures.

Prof. Arunkumar Ram

18

Dept. of Biomedical Engg.

STAPLES

Biomaterials

Module 9

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES

Prof. Arunkumar Ram

19

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
STAPLES

Module 9

Time for a Video

1_GIA Surgical Stapler.mp4

2_surgery simple interrupted suturing

Biomaterials

wound.mp4
(WARNING: Light hearted people close

Prof. Arunkumar Ram

your eyes)
20

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES
Tissue Adhesives
Special

environment

of

tissues

and

their

regenerative capacity makes tissue adhesives

difficult.

Biomaterials

Module 9

Prof. Arunkumar Ram

21

Dept. of Biomedical Engg.

Semester: III
Module 9
Biomaterials

SUTURES, SURGICAL TAPES AND

ADHESIVES
Ideal Characteristics of Tissue Adhesives

Should be able to wet and bond tissue

Be capable of rapid polymerization without

producing much heat or toxic by products

Be Resorbable

Not to interfere with normal healing process

Have ease of applications during surgery

Be Sterilizable

Have adequate shell life

Ease of large scale production

Prof. Arunkumar Ram

22

Dept. of Biomedical Engg.

Semester: III

SUTURES, SURGICAL TAPES AND

ADHESIVES

Alkyl--cyanoacrylate is best know tissue

Module 9

adhesive

With

addition

of

some

plasticizers

and

adhesive they are commercially available as

Biomaterials

Eastman 910, Crazy Glue

Prof. Arunkumar Ram

23

Dept. of Biomedical Engg.

Semester: III
Module 9

SUTURES, SURGICAL TAPES AND

ADHESIVES
700
600
Bond Strength
(grams)

500
400

Suture

300
200

Methyl-2cyanoacrylate

Biomaterials

100
0
1

10

14

TIME (days)

Bond Strength of Wounds with different closure materials

Prof. Arunkumar Ram

24

Dept. of Biomedical Engg.

Semester: III

Bond strength of adhesive treated wound is about

half that of sutured wounds after 10 days.
Because
of lower strength
and lesser
predictability of in vivo performance, this is
limited to use after trauma in fragile tissues or
after extensive surgery in soft tissue.

Biomaterials

Module 9

SUTURES, SURGICAL TAPES AND

ADHESIVES

Prof. Arunkumar Ram

25

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Percutaneous devices (Trans or through the

Module 9

skin)

Artificial kidneys, hearts

Prolonged injection of drugs and nutrients.

Artifical skin (maintaining body temperature of

Biomaterials

several burned patients)

Prof. Arunkumar Ram

26

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Percutaneous Devices

Module 9

Problem of obtaining a functional and viable interface

between the tissue and implant (percutaneous) is due to
following factors
1.

Initial attachment of the implant with the tissue may

occur but this may not continue for a long time

Biomaterials

2.

Dermal tissue cells turn over continuously and dynamically

Down growth of epithelium around the implant may

occur.
3.

Opening large enough may give way for bacteria to

penetrate.

Prof. Arunkumar Ram

27

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Percutaneous Devices

Module 9

Many

variables

are

involved

in

development

of

percutaneous devices
End-use factors

1.

Transmission of information (biopotentials, temperature,

pressure, blood flow rate)

Biomaterials

Energy (electrical stimulation, power for heart assist

device)

Matter (cannula for blood)

Load (attachment of prosthesis)

Prof. Arunkumar Ram

28

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Percutaneous Devices

Biomaterials

Module 9

Many

variables

are

involved

in

development

of

prcutaneous devices
Engineering factors

2.

Material selection: polymers, ceramics, metals, and composites

Design Variation: button, tube, porous or smooth surface.

Mechanical Stresses: soft or hard tissue interface, porous or smooth

interfaces

Prof. Arunkumar Ram

29

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Percutaneous Devices

Module 9

Many

are

involved

in

development

of

prcutaneous devices
Biological factors

3.

Implant host: man, dog, hog, rabbit, sheep, etc

Implant location: abdominal, dorsal, forearm, etc.

Human Factors

4.

Biomaterials

variables

Postsurgical care

Implantation technique

Esthetic look

Prof. Arunkumar Ram

30

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

PD-Skin Interface

Module 9

Epidermis

Dermis

Hypodermis
Biomaterials

Prof. Arunkumar Ram

Fascia

31

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

PD-Skin Interface

Module 9

A.

Interface between epidermis and PD should be completely

sealed against invasin by foreign organisms

B.

Interface between dermis and PD should reinforce the

sealing of A, as well as resist mechanical stresses.

C.

Interface between hypodermis and PD should reinforce the

function of B

D.

Implant material should meet all requirement of an implant

Biomaterials

for soft tissue replacement.

E.

The line where epidermis, air and PD meet is called a three

phase line which is similar to A

Prof. Arunkumar Ram

32

Dept. of Biomedical Engg.

Semester: III
Module 9

PERCUTANEOUS AND SKIN IMPLANTS

Artificial Skin

An example of percutaneous implants.

Material that can adhere to a large(burned) surface

and thus prevent the loss of fluids, electrolytes, and
other biomolecules until the wound is healed.

Biomaterials

Autografting

and

Homografting

are

the

only

permanent skin implant solution available.

Prof. Arunkumar Ram

33

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Artificial Skin

Module 9

Several polymeric materials including reconstituted

collagen have also been tried as burns dressings.

Among them are co-polymers of vinyl chloride and

acetate and methyl-2-cynoacrylate.

Biomaterials

Plastic tapes have sometimes been used to hold skin

grafts during microtoming (ultrathin sectioning)
and grafting procedures.

Prof. Arunkumar Ram

34

Dept. of Biomedical Engg.

Semester: III

PERCUTANEOUS AND SKIN IMPLANTS

Artificial Skin

Module 9

Several polymeric materials including reconstituted

collagen have also been tried as burns dressings.

Among them are co-polymers of vinyl chloride and

acetate and methyl-2-cynoacrylate.

Biomaterials

Plastic tapes have sometimes been used to hold skin

grafts during microtoming (ultrathin sectioning)
and grafting procedures.

Prof. Arunkumar Ram

35

Dept. of Biomedical Engg.

Semester: III
Module 9

MAXILLOFACIAL IMPLANTS
Maxillofacial Implants

The art and science of anatomic, functional, or

cosmetic reconstruction by means of artificial
substitutes of those regions in the maxilla,

Biomaterials

mandible, and face that are missing or defective

because of surgical intervention, trauma, etc.

Prof. Arunkumar Ram

36

Dept. of Biomedical Engg.

Semester: III

MAXILLOFACIAL IMPLANTS
Maxillofacial Implants

Biomaterials

Module 9

There are many polymeric materials available for

extraoral implants which requires
1.

Color and texture should match with the patients

2.

Mechanically and chemically stable

3.

Easily fabricated

Polyvinyl chloride and acetate copolymers Polymethyl

methacrylate silicone and polyurethane rubbers, are
currently used.

Prof. Arunkumar Ram

37

Dept. of Biomedical Engg.

Semester: III

MAXILLOFACIAL IMPLANTS
Maxillofacial Implants

Module 9

For maxillary, mandibular and facial bone defects,

metallic materials such as tantalum, titaniu and Co-Cr
alloys etc. are used.

For soft tissues like gum and chin, polymers such as

Biomaterials

silicone rubber, PMMA etc. are used for augmentation.

Prof. Arunkumar Ram

38

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants

Module 9

The use of implants can restore the

conductive loss from otosclerosis (a heredity defect that

involves a change in the bony tissue of the ear

Chronic otitis media (inflammation of middle ear, which

may cause partial or complete impairment of the ossicular

Biomaterials

chain: malleus, incus and stapes)

Prof. Arunkumar Ram

39

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants
Stapes Prosthesis

Biomaterials

Module 9

Prof. Arunkumar Ram

40

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants
Incus Replacement Prosthesis

Biomaterials

Module 9

Prof. Arunkumar Ram

41

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants
Whole ossicular chain Prosthesis

Biomaterials

Module 9

Prof. Arunkumar Ram

42

Dept. of Biomedical Engg.

Semester: III
Module 9

EAR AND EYE IMPLANTS

Ear Implants

Polyethylene total ossicular replacement

This porous polyethylene total ossicular replacement

implant is used to obtain a firm fixation of the implant by
tissue in growth.
Helps in sound conduction.

Biomaterials

Prof. Arunkumar Ram

43

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants

Biomaterials

Module 9

Materials used

Poly tetra fluoroethylene

Ploy ethylene

Silicone rubber

Stainless steel

Tantalum

Polytetrafluoroethylene-carbon composite (Proplast)

Porous polyethylene (Plastipore)

Pyrolite Carbon (Pyrolite)

Prof. Arunkumar Ram

44

Dept. of Biomedical Engg.

Semester: III

EAR AND EYE IMPLANTS

Ear Implants

Module 9

Artificial Ear Implants capable of processing speech have

been developed and are undergoing clinical evaluation.

Implants have got electrode to stimulate the cochlear

nerve cells.

Also speech processor-converts sound waves into electrical

Biomaterials

signals.

Prof. Arunkumar Ram

45

Dept. of Biomedical Engg.

Ear Implants

Biomaterials

Module 9

Semester: III

EAR AND EYE IMPLANTS

Prof. Arunkumar Ram

46

Dept. of Biomedical Engg.

Semester: III

Ear Implants

3_How the VIBRANT SOUNDBRIDGE Middle Ear

Implant Works.mp4

Biomaterials

Module 9

EAR AND EYE IMPLANTS

Prof. Arunkumar Ram

47

Dept. of Biomedical Engg.

Semester: III
Module 9

EAR AND EYE IMPLANTS

Eye Implants

Eye implants used to restore the functionality of

cornea and lens when they are damaged or diseased.
Cornea is usually transplanted from a suitable donor.

Biomaterials

Prof. Arunkumar Ram

48

Dept. of Biomedical Engg.

Semester: III
Module 9

EAR AND EYE IMPLANTS

Eye Implants

Usually made from transparent acrylics, especially

PMMA, which has a comparatively high refractive
index (1.5)

Intraoccular lenses implanted surgically to replace

Biomaterials

the original eye lens

Prof. Arunkumar Ram

49

Dept. of Biomedical Engg.

Semester: III

Eye Implants

4_Eye Implants For The Blind.avi.mp4

5_Retinal Implants.mp4

Biomaterials

Module 9

EAR AND EYE IMPLANTS

Prof. Arunkumar Ram

50

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Blood Interfacing Implants divided into two categories

Module 9

Short Term Devices

machine)

Biomaterials

Membranes for artificial organs (kidney and heart/lung

Tubes catheters for transport of blood

Long term Implants

Vascular implants

Implantable artificial organs

Pacemakers

Prof. Arunkumar Ram

51

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Requirement for Blood Interfacing Devices

Blood Compatibility

Blood Coagulation

Implant should not cause blood coagulation

Implants should not cause damage to proteins, enzymes,

and blood components (RBC, WBC and Platelets)

Implants should not cause hemolysis (red blood cell

Biomaterials

rupture)

Prof. Arunkumar Ram

52

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Vascular Implants

Module 9

Early Arterial replacements were solid wall tubes made of

glass, aluminum, gold, silver and PMMA.

These implants developed clots and became useless.

1950s porous implants were introduced, but there was tissue

ingrowth. This minimizes clotting.
Proper fixation of the Implant.

Biomaterials

Prof. Arunkumar Ram

53

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Vascular Implants

Module 9

Crimping of Blood vessels done to prevent kinking when the

implants is flexed.

Crimping allows expansion of the graft in the longitudinal

direction which reduces strain on the prosthesis wall.

Arteries expand circumferentially and longitudinally to

Biomaterials

accommodate the pulsatile flow of the blood.

Prof. Arunkumar Ram

54

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Vascular Implants

Biomaterials

Module 9

The type of material, geometry of implant influence the rate

and nature of tissue ingrowth.

No. of polymeric material used to fabricate implants

Nylon

Polyester

PTFE

Polypropylene

Silicon Rubber

Recently a pyrolytic carbon coated arterial graft has been developed by

technique of ULTI deposition

Prof. Arunkumar Ram

55

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

Four Valves in Human body

Left ventricular valves become incompetent more

frequently

More importantly Aortic Valve

Biomaterials

Prof. Arunkumar Ram

56

Dept. of Biomedical Engg.

Heart Valve Implants

Biomaterials

Module 9

Semester: III

BLOOD INTERFACING IMPLANTS

Prof. Arunkumar Ram

57

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

An artificial heart valve is a mechanism that mimics the

function of a human heart valve

Its used for patients with a heart valvular disease or have a

damaged valve

Heart valves are used to provide the heart with a

Biomaterials

unidirectional blood flow

They act as pumps

Prof. Arunkumar Ram

58

Dept. of Biomedical Engg.

Semester: III

Heart Valve Implants

1960s Flexible leaflets that mimicked the natural valves.

But the leaflets could not bear the fatigue for more than 3
Years.

Hemolysis, Regurgitation, incompetence were major problem

Biomaterials

Module 9

BLOOD INTERFACING IMPLANTS

Prof. Arunkumar Ram

59

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

Biomaterials

Module 9

Material Requirement for heart valves same as that of

vascular implants.

Additional requirement of blood flow and pressure regulation.

Formed elements of blood should not be damaged.

Blood pressure should not drop below clinically significant

value.

Prof. Arunkumar Ram

60

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Mechanical- There are three types. The caged ball, tilting

disk, and bi-leaflet
Tissue(biological)- valves that are used from animals to
implant them back into humans

Biomaterials

Module 9

Heart Valve Implants-Types

Prof. Arunkumar Ram

61

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

All the types of mechanical heart valves are still in use today.

Usually made of titanium or carbon which makes them strong

and very durable

Three types of mechanical heart valves

Biomaterials

Prof. Arunkumar Ram

62

Dept. of Biomedical Engg.

Heart Valve Implants

Biomaterials

Module 9

Semester: III

BLOOD INTERFACING IMPLANTS

Prof. Arunkumar Ram

63

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

Using valves from other animals.

The porcine valve of a pig is the
most comparable valve to a human.

Xenotransplantation

Pericardial valves: Biological valve

Biomaterials

tissue can be taken from a cow or

horses pericardial sac and be sewed

to a metal frame.

Prof. Arunkumar Ram

64

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

Module 9

All valves have sewing ring that is covered with various polymeric
fabrics.

This helps during initial fixation of the implant

Later the ingrown tissue will render the fixation viable in a

Biomaterials

manner similar to the porous vascular implants.

The cage itself is usually made of metals and covered with fabrics
to reduce noise, or with pyrolytic carbon.

The disc is coated with pyrolytic carbon at the same time.

Prof. Arunkumar Ram

65

Dept. of Biomedical Engg.

Semester: III

BLOOD INTERFACING IMPLANTS

Heart Valve Implants

Biomaterials

Module 9

The ball (or disc) is usually made of a hollow structure composed

of solid polymers

Polypropylene

Polyoxymethylene

Polychlorotrifluoroethylene

Metals (titanium, Co-Cr alloys)

or pyrolytic carbon deposited on graphite

substrate.

Prof. Arunkumar Ram

66

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants-Advantages

Mechanical heart valves: The biggest advantage is the

durability. While the tissue heart valves are estimated to last

about 10-15 years, a mechanical heart valve can last 30 year

Biomaterials

Tissue heart valves: There is minimal blood regurgitation,

minimal transvalvular pressure gradient, self repairing.

Does not require and anti-coagulant drug.

Prof. Arunkumar Ram

67

Dept. of Biomedical Engg.

Heart Valve Implants-Disadvantages

Mechanical heart valves In order to decrease the risk of

Module 9

Semester: III

BLOOD INTERFACING IMPLANTS

blood clotting, the patient must take blood thinners. Some

patients can hear their mechanical heart valve open and
close.

Tissue heart valves Wear, there is a small possibility that the

Biomaterials

body will reject the valve, inability to implant them into infants
and children.
.

Prof. Arunkumar Ram

68

Dept. of Biomedical Engg.

Semester: III
Module 9

BLOOD INTERFACING IMPLANTS

Heart Valve Implants-Implanting

Both mechanical and tissue heart valves require open heart

surgery

Its more common in tissue valves for a re-operation

Complete recovery from surgery could be a couple of weeks

Biomaterials

to several months

Currently: 55% mechanical valves

45% tissue valves

Prof. Arunkumar Ram

69

Dept. of Biomedical Engg.

Semester: III
Module 9
Biomaterials

ARTIFICIAL ORGANS

Artificial Heart

Useful for short term use in keeping the patients with

end stage heart disease alive until a transplant heart
becomes available.

Concern is the power supply

Externally powered supply

Can keep alive person for 112 days

But external connection restricted the movements.

Prof. Arunkumar Ram

70

Dept. of Biomedical Engg.

Artificial Heart

Biomaterials

Module 9

Semester: III

ARTIFICIAL ORGANS

Prof. Arunkumar Ram

71

Dept. of Biomedical Engg.

Artificial Heart

Biomaterials

Module 9

Semester: III

ARTIFICIAL ORGANS

Prof. Arunkumar Ram

72

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Pacemakers

Module 9

A cardiac pacemaker use to assist the regular contraction rhythm

of heart muscles.

It should deliver the exact amount of electrical stimulation to the

heart at varying heart rates.
Consist of conducting electrodes attached to stimulator.

Biomaterials

Prof. Arunkumar Ram

73

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Pacemakers

Module 9

Electrodes are well insulated with rubber (usually silicone or

polyurethane) except for tip which is sutured or directly
embedded into the cardiac wall.

The tip is usually made up of non corrosive noble metal with

reasonable mechanical strength such as Pt-10%Ir Alloy.

Biomaterials

The most significant problems are the fatigue of the electrodes

(they are coiled like spring to prevent this) and formation of

collagenous scar tissue at the tip, which increases threshold
electrical resistance at the point of tissue contact.

Prof. Arunkumar Ram

74

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Pacemakers

Biomaterials

Module 9

Battery and electronic components are sealed by a titanium case

while the electrodes outlet are sealed by polypropylene cuff.

Changed after 2-5 years due to limitation of the power source.

Nuclear powered pacemaker is also commercially available.

Lithium powered batteries now available

Prof. Arunkumar Ram

75

Dept. of Biomedical Engg.

Pacemakers

Biomaterials

Module 9

Semester: III

ARTIFICIAL ORGANS

Prof. Arunkumar Ram

76

Dept. of Biomedical Engg.

Semester: III

Artificial Kidney Dialysis Membrane

Primary function of kidney to remove metabolic waste product.

Achieved by passing blood through glomerulus under a pressure

about 75 mm Hg.

Biomaterials

Module 9

ARTIFICIAL ORGANS

Prof. Arunkumar Ram

77

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Biomaterials

Module 9

The main filtrate is urea (70 times the urea content of normal
blood)

Sodium

Chloride

Bicarbonated

Potassium

Glucose

Creatinine and uronic acid

Prof. Arunkumar Ram

78

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Module 9

Artificial kidney uses a synthetic semipermeable membrane to

perform the filtering action in a way similar to that of a natural
kidney

The membrane is the key component of the artificial kidney

machine.

Biomaterials

In addition it also consists of a bath of saline fluid into which the

waste products diffuse out from the blood to a vein.

Prof. Arunkumar Ram

79

Dept. of Biomedical Engg.

Artificial Kidney Dialysis Membrane

Biomaterials

Module 9

Semester: III

ARTIFICIAL ORGANS

Prof. Arunkumar Ram

80

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Three types of kidney dialyzers are available

Biomaterials

Module 9

Prof. Arunkumar Ram

81

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Module 9

Flat Plate Dialyzer

First developed and have two or four layers.

Blood passes through the spaces between the membrane layers while the

dialysate passes through the spaces between the membrane and restraining

Biomaterials

boards.

Prof. Arunkumar Ram

82

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Coil Membrane

Consist of two cellophane tubes (9 cm in circumference and 108 cm long) are

flattened and coiled with an open mesh spacer material of nylon.

Biomaterials

Module 9

Prof. Arunkumar Ram

83

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Module 9

Hollow Fiber Membrane

Made up of hollow fibers

Each fibers have dimension of 255 and 285 um inside and outside diameter and

13.5 cm long.

Each unit contains about 11,000 hollow fibers.

The blood flows through the fibers while dialysate is passed outside of the

Biomaterials

fibers

Prof. Arunkumar Ram

84

Dept. of Biomedical Engg.

Semester: III

ARTIFICIAL ORGANS

Artificial Kidney Dialysis Membrane

Module 9

The fibers can also be made from (soda-lime) glass which is made
porous by phase separation techniques.

Can be cleaned and sterilized.

Majority membranes are made up of cellophanes, which is derived

Biomaterials

from cellulose.

Cupraphane

Visking

Prof. Arunkumar Ram

85

Dept. of Biomedical Engg.