Abstract
Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC) act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC) to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and maintained their metabolic activity. Furthermore, cell-filled sutures can be cryopreserved without losing their viability. This study presents an innovative approach to equip surgical sutures with pro-regenerative features and allows the treatment and fixation of wounds in one step, therefore representing a promising tool to promote wound healing after injury.
Highlights
Insufficient wound healing after tissue injury is associated with an increased risk of infection, loss of tissue functionality, and scar formation, generating patient discomfort and elevating treatment expenses
Wound healing occurs in three dynamic phases: inflammation, proliferation, and remodeling, which are orchestrated by auto- and paracrine mechanisms
A multitude of cell types are involved in these processes, it is highly recognized that mesenchymal stem cells (MSCs) play a key role in the promotion of wound healing [1,2,3,4]
Summary
Insufficient wound healing after tissue injury is associated with an increased risk of infection, loss of tissue functionality, and scar formation, generating patient discomfort and elevating treatment expenses. Wound healing occurs in three dynamic phases: inflammation, proliferation, and remodeling, which are orchestrated by auto- and paracrine mechanisms. Current perspectives highlight their ability to secrete regulatory molecules that act either directly by auto- or paracrine signaling or indirectly as trophic mediators. This capacity enables MSCs to create a regenerative microenvironment at sites of tissue damage by fostering key processes in wound healing such as immunosuppression, cell homing, and migration [7,8,9,10]. The combined use of MSCs and biomaterials is promising for tissue engineering and regeneration and has been successfully used in pre- and clinical trials, describing accelerated healing of human cutaneous wounds after application of an MSC-loaded fibrin spray [11]
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