Comet-Tail-Like Inflammatory Infiltrate to Polymer Filaments Develops in Tension-Free Conditions

Klink, Christian D.; Binnebösel, Marcel; Kaemmer, Daniel; Schachtrupp, A.; Fiebeler, Anette; Anurov, M.; Schumpelick, Volker; Klinge, U.

doi:10.1159/000322250

Cited by 14 publications

(21 citation statements)

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“…We evaluated the extent and the cellular quality of foreign body granuloma and the CTI. This phenomenon was described in 2002 by Hoer et al [20], and other studies identified the CTI as a tool to investigate the reaction of the host tissue to the surface of the foreign body itself even under tension-free conditions [10]. …”

Section: Discussionmentioning

confidence: 99%

“…Three different suture materials of 2 cm length were randomized and were placed subcutaneously by puncture of the abdominal wall (n = 15 for each suture) like previously described by Klink et al [10]. After 3, 7 or 21 days (n = 5 for each suture), the animals were euthanized using a lethal dose of pentobarbital sodium (Narcoren®, Rhône Merieux, Laupheim).…”

Section: Methodsmentioning

confidence: 99%

“…As a central tool of investigation, we assessed the extent and the cellular quality of foreign body granuloma and the comet tail-like infiltrate (CTI). This way, the reaction of the host tissue to the surface of the foreign body itself has been previously investigated [10]. To have a reliable spectrum of materials in comparison to PVDF, we assembled a set of 5 different suture materials which were monofilamental and polyfilamental as well as absorbable and nonabsorbable sutures to be able to evaluate different aspects influencing the biocompatibility.…”

Section: Introductionmentioning

confidence: 99%

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Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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Background: Biocompatibility and tissue integration of a surgical suture are decisive factors for wound healing and therefore for the success of sutures. The optimal suture material is still under discussion. Polyvinylidene fluoride (PVDF) is described to have superior properties of biocompatibility and is therefore frequently used as a mesh component. Only little information is available about its use as a suture material. The aim of this study was to evaluate the biocompatibility of PVDF as a suture material in comparison to 5 different established sutures in a rat model. Methods: In 30 male rats, a monofilamental PVDF suture (Resopren®) and 5 established control suture materials [polyester (Miralene®), polytetrafluoroethylene (Gore®), poliglecaprone (Monocryl®), polydioxanone (Monoplus®), polyglactin 910 (Vicryl®), USP size 3-0] were placed in the subcutaneous layer of the abdominal wall without knot or tension. After 3, 7 or 21 days, the abdominal walls were explanted for histopathological and immunohistochemical investigation with special regard to the size and quality of foreign body granuloma and the length of the comet tail-like infiltrate (CTI). Results: The PVDF sutures showed the smallest size of foreign body granuloma (60 ± 14 µm) and the smallest CTI length (343 ± 60 µm) of all polymers after 21 days. Only PVDF (Resopren) and polydioxanone (Monoplus) showed a significant collagen I/III ratio increase between days 3 and 21 (p = 0.009 and p = 0.016). The quality of foreign body reaction regarding inflammation, proliferation and fibrotic remodeling was similar between all suture materials. Conclusions: Our data indicate that monofilamental PVDF sutures show a favorable foreign body reaction with small granuloma sizes and CTI length in comparison to established sutures. Its use as a suture material in general surgery could therefore be extended in the future. To reinforce these findings, further clinical studies need to be conducted.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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“…In addition to TNM, the expression of several proteins involved in tumour genesis, particularly Gas6, and the number of infiltrating macrophages (CD68) were analysed. In addition, the proteins Notch 3, MMP2 and COX2, were researched to confirm their roles during chronic inflammation and foreign body responses [12]. Each variable was analyzed individually for its prognostic value and subjected to multiple Cox regression analysis.…”

Section: Introductionmentioning

confidence: 99%

Formation of translational risk score based on correlation coefficients as an alternative to Cox regression models for predicting outcome in patients with NSCLC

Kössler

Fiebeler

Willms³

et al. 2011

Theor Biol Med Model

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BackgroundPersonalised cancer therapy, such as that used for bronchial carcinoma (BC), requires treatment to be adjusted to the patient's status. Individual risk for progression is estimated from clinical and molecular-biological data using translational score systems. Additional molecular information can improve outcome prediction depending on the marker used and the applied algorithm. Two models, one based on regressions and the other on correlations, were used to investigate the effect of combining various items of prognostic information to produce a comprehensive score. This was carried out using correlation coefficients, with options concerning a more plausible selection of variables for modelling, and this is considered better than classical regression analysis.MethodsClinical data concerning 63 BC patients were used to investigate the expression pattern of five tumour-associated proteins. Significant impact on survival was determined using log-rank tests. Significant variables were integrated into a Cox regression model and a new variable called integrative score of individual risk (ISIR), based on Spearman's correlations, was obtained.ResultsHigh tumour stage (TNM) was predictive for poor survival, while CD68 and Gas6 protein expression correlated with a favourable outcome. Cox regression model analysis predicted outcome more accurately than using each variable in isolation, and correctly classified 84% of patients as having a clear risk status. Calculation of the integrated score for an individual risk (ISIR), considering tumour size (T), lymph node status (N), metastasis (M), Gas6 and CD68 identified 82% of patients as having a clear risk status.ConclusionCombining protein expression analysis of CD68 and GAS6 with T, N and M, using Cox regression or ISIR, improves prediction. Considering the increasing number of molecular markers, subsequent studies will be required to validate translational algorithms for the prognostic potential to select variables with a high prognostic power; the use of correlations offers improved prediction.

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“…The presence of a more severe host response, leading to an excessive inflammatory and fibrotic response, could lead to more complications . A first indicator for this host response is the general composition and size of the foreign body granuloma surrounding the biomaterial . The granuloma is a cellular infiltrate of mainly macrophages directly surrounding the material and a fibrotic capsule separating the material from the host with elongated comet‐tail like infiltrates running parallel to the skin and muscle .…”

Section: Discussionmentioning

confidence: 99%

Biocompatibility and biomechanical analysis of elastic TPU threads as new suture material

et al. 2015

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High suture tension is one of the causes for many wound-healing problems. Constriction of tissue within the suture loops of nonelastic sutures can lead to cutting of the suture through tissues and necrosis of the tissue within these loops. The use of elastic materials in new suture types could give the material the ability to adapt tension to the tissue requirements and subsequently lead to more vital tissue within its loops. We evaluated the foreign body host response, as indicator of biocompatibility, to a new thermoplastic poly(carbonate) urethane (TPU) synthetic suture material in a rat model compared with standard nonelastic polypropylene (PP) sutures. Tissue samples were collected at 7 and 21 days, and host response was evaluated. Subsequently, suture tension curves of the new elastic sutures for the first 30 min after knotting were recorded in a pig model. The new TPU sutures showed an improved foreign body response when compared with that of PP, with a reduction in the amount of macrophages surrounding the material. Tension experiments showed a superior tension curve for TPU sutures, with a major reduction in peak suture tension when compared with that of standard PP sutures, while still retaining adequate tension after 30 min. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 99-106, 2017.

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Comet-Tail-Like Inflammatory Infiltrate to Polymer Filaments Develops in Tension-Free Conditions

Cited by 14 publications

References 70 publications

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Formation of translational risk score based on correlation coefficients as an alternative to Cox regression models for predicting outcome in patients with NSCLC

Biocompatibility and biomechanical analysis of elastic TPU threads as new suture material

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