Abstract
In this study we investigated how hemostats such as oxidized regenerated cellulose (ORC, TABOTAMP) and oxidized non-regenerated cellulose (ONRC, RESORBA CELL) influence local cellular behavior and contraction of the extracellular matrix (ECM). Human stromal fibroblasts were inoculated in vitro with ORC and ONRC. Cell proliferation was assayed over time, and migration was evaluated by Live Cell imaging microscopy. Fibroblasts grown in collagen-gels were treated with ORC or ONRC, and ECM contraction was measured utilizing a contraction assay. An absolute pH decline was observed with both ORC and ONRC after 1 hour. Mean daily cell proliferation, migration and matrix contraction were more strongly inhibited by ONRC when compared with ORC (p < 0.05). When control media was pH-lowered to match the lower pH values typically seen with ORC and ONRC, significant differences in cell proliferation and migration were still observed between ONRC and ORC (p < 0.05). However, in these pH conditions, inhibition of matrix contraction was only significant for ONRC (p < 0.05). We find that ORC and ONRC inhibit fibroblast proliferation, migration and matrix contraction, and stronger inhibition of these essential cellular processes of wound healing were observed for ONRC when compared with ORC. These results will require further validation in future in vivo experiments to clarify the clinical implications for hemostat use in post-surgical wound healing.
Highlights
Postoperative wound healing is highly dependent on the interaction between different cell lines; fibroblasts seem to be of particular relevance for deep incisional wound healing (DIWH)
Human fibroblasts were used for analyzing key cellular sub-processes
As degradation of ORC and ONRC initially consists of hydrolysis with release of acidic groups, we investigated the pH-value time course for both hemostats
Summary
Decline in pH value occurred during the first hour before equilibration. No difference in total pH value decline between ORC and ONRC. Both hemostats had lower pH values compared to controls (*p < 0.05 between 1–5 h and at 240 h). ONRC showed lower pH value throughout the investigation period compared to ORC (*p < 0.05; oneway ANOVA with Bonferroni post test). The objective of this study is to compare an ONRC-based hemostat (RESORBA CELL, Resorba, Nuremberg, Germany) with an ORC-based hemostat (TABOTAMP, Norderstedt, Germany) regarding their effects on fundamental processes of deep incisional wound healing (DIWH), including cell proliferation and migration, and contraction of the extracellular matrix (ECM)
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