Compamed Report on High-Tech Constructions for the Human Body

Messe Düsseldorf, the organisers of the annual Compamed medical technology manufacturing trade show, which takes at the same time and days as the international Medica healthcare trade show in Düsseldorf, Germany, has provided a report on Compamed's Spring Forum conference, held on April 25, 2013, in Stuttgart.

The report is as follows.

The Compamed Spring forum has become as much a part of the furniture as the Compamed in Düsseldorf - the leading international specialist trade fair for suppliers to the medical technology industry which has been held every year in November since 1992. Starting a good six months before the start of the fair (Compamed 2013: 20th – 22nd November), each year it offers a great opportunity for all experts from product development and production process from the supplier side, medical technology industry, and research, to hear about the latest trends and exchange knowledge in discussions.

At the 7th Compamed Spring Forum, jointly coordinated by the IVAM Association for Microtechnology and the Messe Düsseldorf (held in Stuttgart on April 25th), the latest findings from the recovery, replacement and support of body parts area, including functions, featured prominently. The broad range of content adequately reflected the topic of the meeting "Microsystem technology evolution: sophisticated high-tech constructions for the human body - exoskeletons, endoprotheses, neuroprotheses, and bio-implants".

As an example, scientists at the University of Rostock are currently exploring the highly topical issue of 3D printing in the medical technology sector. 3D printing of patient-specific implants is being researched by the Institute of Fluid Technology and Micro-fluid Technology (LFM). Additive manufacturing–the use of 3D printing technology–has considerable potential to reduce the costs of manufacturing implants. At the University of Rostock, this method is being used to manufacture individual, absorbable bone replacement implants. This is a powder-based procedure for the manufacture of models in layers directly from computer data. Thin layers of a powder are added to a base plate, which are then solidified by adding a special additive, based on the current cross-section of the component. "The base material is a granulate mixture based on calcium phosphate, which, as an anorganic component of bone, is ideally suited for healing bone defects", explained Engineer Christian Polzin from LFM. A print head is used to make the granulate adhere with a dextrine solution. The printed 3D models are sintered in the powder bed after sufficient time for curing. The growth and decomposition behaviour can be adjusted individually through the choice of the materials and the design of the bone replacement implants.

Pins from "artificial" bones

Speaking of calcium phosphate: this material is also ideal for bio-absorbable bone pins and implants. These are intended to replace standard metal elements for stabilising bones – usually made of medical steel or titanium. This means operative procedures for removing the metal are no longer necessary. The DRK Clinics of Wesermünde are working with the Institute for Ceramic Materials and Components at the University of Bremen and the Fraunhofer Institute for Production Technology and Applied Material Research (IFAM) are working on alternatives. "With the aid of the spray cast procedure and special temperature and pressure conditions, we have managed to manufacture biomechanically-resistant mouldings from calcium phosphate, in this case, hydroxyapatite. These mouldings can be implemented as pins in bones in experimental procedures", as reported at the 7th Compamed Spring forum by Prof.. Ulrich Wagner, orthopaedic and trauma surgeon at the DRK Seepark Clinic Debsedt. The load capacity is around 130 Newtons per square millimetre. Initial cell culture investigations with humane osteoblasts (cells responsible for bone formation) point to a high level of bio-compatibility in bone cell cultures. More investigations using peeling tests on knee and shoulder joints in humans and cattle are likely to clarify their biomechanical properties.

Flexible thin-film circuits for medical applications are made by Reinhardt Microtech GmbH in Ulm, a member of the Swiss Cicor Group. The unit in Ulm is a manufacturer of sophisticated micro-electronics in the circuit support area especially in the thin-layer technology sector, which offers enormous benefits thanks to its high flexibility and long-term stability. Different plastics such as polyimides, aromatic polyesters, polytetrafluorethylene and polydimethylsiloxanes, are used as materials for the flexible circuits, which are then coated with different metals, such as gold and copper, to construct the circuits. The areas of application for such implants range from "intelligent contact lenses", which detect and treat glaucoma (green star) early, or can measure eye pressure; to apnoea implants; to blood sugar sensors and optical cardiac catheters. "We have the infrastructure to implement customer-specific product solutions at the highest level", Dr. Alexander Kaiser from Reinhardt Microtech stated at the Compamed Spring forum.

Neuroprosthetic interface system between the brain and spinal cord

The European project "NEUWalk", coordinated by the Institute for Microtechnology of Mainz, is also working on top-notch micro-system technology. A consortium of leading European research institutes and companies has brought together expertise for realising a new generation of neuroprosthetic systems. With their help, in future it should become possible to restore a patient's movement after serious spinal cord injuries and also alleviate the symptoms of Parkinson's disease effectively. The project was launched in June 2010 and is being financed by the EU's 7th Framework program for Research and Technology Development with almost nine million Euros. "NEUWalk" will apply very sophisticated decoding algorithms to extract real-time information about the person’s locomotion intent by recording brain signals and translating them into suitable protocols for spinal cord stimulation, triggering the movement functions. Realisation of these neuroprotheses requires new solutions to be explored, based on sophisticated micro-technological and micro-electronic techniques. These include flexible, implantable multi-electrodes and microprocessor-controlled neuroprotheses, which unite both cable-less power and signal transmission and highly-developed opportunities for neurostimulation and neuronal recording and evaluation. "The potential significance of the solutions developed in NEUWalk and neurosurgical treatment strategies is enormous", says Dr. Peter Detemple, Head of the microstructuring and sensor systems at IMM and Coordinator of NEUWalk.

Developments in the area of artificial tissue

The manufacture of artificial tissue for implants has been at the forefront of medical research for some time now and is thus again a topic at Compamed. A big challenge in this area is to provide multilayered cell structures which can be supplied with nutrients via a supply system. A consortium from 16 European partners from industry and research is working on this task under the guise of the Fraunhofer Institute for Laser Technology, ILT. This project–termed "ArtiVasc 3D" has received 7.8 million Euros of funding from the EU, again as part of the 7th Supporting programme. A team of engineers, scientists and doctors are hoping to develop a new method for growing artificial replacement tissue. The tissue has to be vascularised– in other words, to be given a supply system which resembles the natural network of arteries. In the coming four years, through the combination of various technologies from the area of rapid prototyping and biofunctionalisation, the plan is to develop a process which allows for vascular vessels to be built in combination with a support system. These vessels and the support system are to be seeded with autologous cells thus allowing the construction of fat tissue, and ultimately artificial skin. One purpose of this artificial skin is as an in-vitro test system to reduce testing on animals for instance, another is to allow it to be used directly in skin implants.

How large molecular entities get into the body

Large molecular entities such as proteins, hormones or antibodies are very hard to administer since, when administered orally, they are broken down by the gastrointestinal system or the liver, but in most cases do not penetrate the topmost skin layer given transdermal administration. Working together with Pantec Biosolutions AG (Liechtenstein), the Swiss Centre Suisse d’Electronique et de Microtechnique (CSEM), under the name P.L.E.A.S.E (Painless Laser Epidermal System) has developed a new solution in this project which is reported to greatly simplify in-Vitro-fertilisation. The compact unit, which contains a diode-pumped Er:YAG laser, should enable a painless, exceptionally precise, intraepidermal microporation of the skin for the first time. The subsequent administration of medication through the perforated skin takes place by means of appropriate plasters. "The laser pulses only last 100 microseconds. In future, our device will be able to replace many injections", predicts Dirk Fengels, who leads the Sensors & Systems at CEM.

The above topics covered at the 7th Compamed Spring forum give a look at the performance of suppliers of the medical technology industry, themselves working on suitable solutions to very complex issues.

The offering from almost 700 exhibitors at Compamed 2013 is similarly wide-ranging, and being held Mid-November in Düsseldorf, ranging from new materials and pre-products to packaging and services, to complex order production, microsystem- and nanotechnology. This interesting mix is attracting more and more visitors each year. Of the total of 130,600 visitors to Compamed 2012 and to Medica 2012, which are held in parallel, the largest medical trade fair with over 4,500 exhibitors, a good 16,000 were specifically interesting in the topics addressed at Compamed.

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