Synthetic Electrospun Fiber Matrix May Resemble Fungal Hyphae Over the Course of Tissue Regeneration: A Retrospective Review

Abstract

Peripheral soft tissue resections offer unique wound care challenges, often leaving large surgical deficits that are slow to heal and prone to infection. Musculoskeletal surgeons have taken to utilizing a synthetic electrospun fiber matrix (SEFM) to aid in soft tissue repair. SEFM is an engineered, fully resorbable, electrospun fiber matrix engineered to mimic human extracellular matrix supporting cell ingrowth, retention, and differentiation. In addition, in vitro studies have shown SEFM to be effective at inhibiting growth of the most common bacterial and fungal organisms found in surgical site infections. However, little is reported about the histologic features of intact and resorbing SEFM in vivo. Upon investigation, it was observed that the SEFM may resemble fungal hyphae during its 1-3 week degradation via hydrolysis. Special stains for fungi and acid-fast bacilli display positivity in SEFM, further complicating precise diagnosis. Although these specimens should still be carefully evaluated for fungal organisms, it is important to note these potential pitfalls to avoid misdiagnosis, avoid the premature removal of SEFM, and avoid initiation of inappropriate anti-fungal therapy.