Surgical Sutures Filled with Adipose-Derived Stem Cells Promote Wound Healing

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.

Suture materials — Current and emerging trends

“…Previous reports on the use of stem cells coated biosutures in colonic anastomosis showed no effect in anastomotic healing, 198 whereas, colonic anastomosis with peritoneal installation of icodextrin 4% (adhesion-free environment) the biosutures displayed more resistance than conventional sutures. 199 More recently, Reckhenrich et al 155 reported biodegradable suture filled with ASCs showed equal distribution of cells across the filament with improved viability and increase metabolic activity of cells with release of cytokines from in vitro wound healing assay. Furthermore, sutures modified with mesenchymal stem cells showed abundant deposition of collagen alpha-1(I) chain with rapid recovery on wound healing.…”

Age-Related Changes in the Regenerative Potential of Adipose-Derived Stem Cells Isolated from the Prominent Fat Pads in Human Lower Eyelids

“…Adipose-derived stem cells (ASCs) are a population of postnatal progenitor cells existing abundantly in adipose tissue, which can expand rapidly in vitro , possess multilineage differentiation potentials and remain stable over long-term culture [1,2]. Compared to the adult stem cells derived from other tissue sources, such as bone marrow, muscle, ligament, synovium and dental pulp, the advantages of ASCs include the large quantities of fat tissue, minimal patient discomfort, little donor-site morbidity and ease of cell isolation [3,4].…”

Adipose-Derived Stem Cells, their Secretome, and Wound Healing

“…In 2013, ASCs were used for skin defects without skin grafts, and observation showed rapid coverage of wounds with the patient's own regenerated tissue [13]. Furthermore, Reckhenrich et al [14] did a study on the use of an innovative surgical suture filled with ASCs. Their results showed a decrease in open wound area compared to control methods, but this advantage came with a suture with less stiffness and less maximum force [14].…”

“…Furthermore, Reckhenrich et al [14] did a study on the use of an innovative surgical suture filled with ASCs. Their results showed a decrease in open wound area compared to control methods, but this advantage came with a suture with less stiffness and less maximum force [14]. During this study, VEGF was released by the sutures for about 16 days in vitro.…”