Collagen-based biomaterials are a viable option for tendon reconstruction and repair. However, the weak mechanical strength of collagen constructs is a major limitation. We have previously reported a novel methodology to form highly oriented electrochemically aligned collagen (ELAC) threads with mechanical properties converging on those of the natural tendon. In this study, we assessed the in vivo response of rabbit patellar tendon (PT) to braided ELAC bioscaffolds. Rabbit PTs were incised longitudinally and the ELAC bioscaffold was inlaid in one limb along the length of the tendon. The contralateral limb served as the sham-operated control. Rabbits were euthanized at 4 or 8 months postoperatively. High-resolution radiographs revealed the absence of ectopic bone formation around the bioscaffolds. Four months post-implantation, the histological sections showed that the ELAC bioscaffold underwent limited degradation and was associated with a low-grade granulomatous inflammation. Additionally, quantitative histology revealed that the cross-sectional areas of PTs with the ELAC bioscaffold were 29% larger compared with the controls. Furthermore, ELAC-treated PTs were significantly stiffer compared with the controls. The volume fraction of the tendon fascicle increased in the ELAC-treated PT compared with the controls. By 8 months, the ELAC bioscaffold was mostly absorbed and the enlargement in the area of tendons with implants subsided along with the resolution of the granulomatous inflammation. We conclude that ELAC is biocompatible and biodegradable and has the potential to be used as a biomaterial for tendon tissue engineering applications.
The incidence of large open wounds in the US is estimated to be about 5–7 million per year which results in a cost of greater than $20 billion for wound management [1]. Large open wounds occur due to burns, trauma, and secondary to surgical interventions, ulcers or pressure sores. The current clinical practice is to treat large open wounds by delayed primary closure where skin is stretched under constant tension to approximate wound edges by relying on the extensibility of the neighboring skin, by skin grafting or by managing the wound to heal by second intention. Delayed primary closure is inapplicable when the strength of the skin is compromised (e.g. age, diabetes). Furthermore, delayed primary closure usually leads to excessive wound tension which introduces hypertrophic scars [2] and ischemia [3] to the skin and the underlying muscles. Skin autografts may result in morbidity of the donor site. Therefore, there is the need for noninvasive methods which will enable large wound closure in a reasonable time frame with minimal scar formation while alleviating or reducing the need for skin graft harvest.
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