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Moreno S, Massee M, Campbell S, Bara H, Koob TJ, Harper JR. PURION ® processed human amnion chorion membrane allografts retain material and biological properties supportive of soft tissue repair. J Biomater Appl 2024; 39:24-39. [PMID: 38616137 PMCID: PMC11118792 DOI: 10.1177/08853282241246034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
The reparative properties of amniotic membrane allografts are well-suited for a broad spectrum of specialties. Further enhancement of their utility can be achieved by designing to the needs of each application through the development of novel processing techniques and tissue configurations. As such, this study evaluated the material characteristics and biological properties of two PURION® processed amniotic membrane products, a lyophilized human amnion, intermediate layer, and chorion membrane (LHACM) and a dehydrated human amnion, chorion membrane (DHACM). LHACM is thicker; therefore, its handling properties are ideal for deep, soft tissue deficits; whereas DHACM is more similar to a film-like overlay and may be used for shallow defects or surgical on-lays. Characterization of the similarities and differences between LHACM and DHACM was conducted through a series of in vitro and in vivo studies relevant to the healing cascade. Compositional analysis was performed through histological staining along with assessment of barrier membrane properties through equilibrium dialysis. In vitro cellular response was assessed in fibroblasts and endothelial cells using cell proliferation, migration, and metabolic assays. The in vivo cellular response was assessed in an athymic nude mouse subcutaneous implantation model. The results indicated the PURION® process preserved the native membrane structure, nonviable cells and collagen distributed in the individual layers of both products. Although, LHACM is thicker than DHACM, a similar composition of growth factors, cytokines, chemokines and proteases is retained and consequently elicit comparable in vitro and in vivo cellular responses. In culture, both treatments behaved as potent mitogens, chemoattractants and stimulants, which translated to the promotion of cellular infiltration, neocollagen deposition and angiogenesis in a murine model. PURION® processed LHACM and DHACM differ in physical properties but possess similar in vitro and in vivo activities highlighting the impact of processing method on the versatility of clinical use of amniotic membrane allografts.
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Sorg H, Tilkorn DJ, Hauser J, Ring A. Improving Vascularization of Biomaterials for Skin and Bone Regeneration by Surface Modification: A Narrative Review on Experimental Research. Bioengineering (Basel) 2022; 9:bioengineering9070298. [PMID: 35877349 PMCID: PMC9311595 DOI: 10.3390/bioengineering9070298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 07/02/2022] [Indexed: 11/30/2022] Open
Abstract
Artificial tissue substitutes are of great interest for the reconstruction of destroyed and non-functional skin or bone tissue due to its scarcity. Biomaterials used as scaffolds for tissue regeneration are non-vascularized synthetic tissues and often based on polymers, which need ingrowth of new blood vessels to ensure nutrition and metabolism. This review summarizes previous approaches and highlights advances in vascularization strategies after implantation of surface-modified biomaterials for skin and bone tissue regeneration. The efficient integration of biomaterial, bioactive coating with endogenous degradable matrix proteins, physiochemical modifications, or surface geometry changes represents promising approaches. The results show that the induction of angiogenesis in the implant site as well as the vascularization of biomaterials can be influenced by specific surface modifications. The neovascularization of a biomaterial can be supported by the application of pro-angiogenic substances as well as by biomimetic surface coatings and physical or chemical surface activations. Furthermore, it was confirmed that the geometric properties of the three-dimensional biomaterial matrix play a central role, as they guide or even enable the ingrowth of blood vessels into a biomaterial.
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Affiliation(s)
- Heiko Sorg
- Department of Plastic and Reconstructive Surgery, Marien Hospital Witten, Marienplatz 2, 58452 Witten, Germany;
- Department of Health, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany
| | - Daniel J. Tilkorn
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Alfried Krupp Krankenhaus, Hellweg 100, 45276 Essen, Germany; (D.J.T.); (J.H.)
| | - Jörg Hauser
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Alfried Krupp Krankenhaus, Hellweg 100, 45276 Essen, Germany; (D.J.T.); (J.H.)
| | - Andrej Ring
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, St. Rochus Hospital Castrop-Rauxel, Katholische St. Lukas Gesellschaft, Glückaufstraße 10, 44575 Castrop-Rauxel, Germany
- Correspondence: ; Tel.: +49-2305-294-2801
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Haller HL, Sander F, Popp D, Rapp M, Hartmann B, Demircan M, Nischwitz SP, Kamolz LP. Oxygen, pH, Lactate, and Metabolism-How Old Knowledge and New Insights Might Be Combined for New Wound Treatment. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111190. [PMID: 34833408 PMCID: PMC8617754 DOI: 10.3390/medicina57111190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
Over time, we have come to recognize a very complex network of physiological changes enabling wound healing. An immunological process enables the body to distinguish damaged cells and begin a cleaning mechanism by separating damaged proteins and cells with matrix metalloproteinases, a complement reaction, and free radicals. A wide variety of cell functions help to rebuild new tissue, dependent on energy provision and oxygen supply. Like in an optimized “bio-reactor,” disturbance can lead to prolonged healing. One of the earliest investigated local factors is the pH of wounds, studied in close relation to the local perfusion, oxygen tension, and lactate concentration. Granulation tissue with the wrong pH can hinder fibroblast and keratinocyte division and proliferation, as well as skin graft takes. Methods for influencing the pH have been tested, such as occlusion and acidification by the topical application of acidic media. In most trials, this has not changed the wound’s pH to an acidic one, but it has reduced the strong alkalinity of deeper or chronic wounds. Energy provision is essential for all repair processes. New insights into the metabolism of cells have changed the definition of lactate from a waste product to an indispensable energy provider in normoxic and hypoxic conditions. Neovascularization depends on oxygen provision and lactate, signaling hypoxic conditions even under normoxic conditions. An appropriate pH is necessary for successful skin grafting; hypoxia can change the pH of wounds. This review describes the close interconnections between the local lactate levels, metabolism, healing mechanisms, and pH. Furthermore, it analyzes and evaluates the different possible ways to support metabolism, such as lactate enhancement and pH adjustment. The aim of wound treatment must be the optimization of all these components. Therefore, the role of lactate and its influence on wound healing in acute and chronic wounds will be assessed.
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Affiliation(s)
| | - Frank Sander
- Burn Center, Plastic Surgery of Trauma Hospital Berlin, Warener Strasse 7, 12683 Berlin, Germany; (F.S.); (B.H.)
| | - Daniel Popp
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
| | - Matthias Rapp
- Clinic for Orthopedics, Trauma Surgery and Sports Traumatology, Burn Center, Marienhospital Stuttgart, Böheimstraße 37, 70199 Stuttgart, Germany;
| | - Bernd Hartmann
- Burn Center, Plastic Surgery of Trauma Hospital Berlin, Warener Strasse 7, 12683 Berlin, Germany; (F.S.); (B.H.)
| | - Mehmet Demircan
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, Faculty of Medicine, İnönü University, 44315 Malatya, Turkey;
| | - Sebastian Philipp Nischwitz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgsellschaft mbH, 8036 Graz, Austria
| | - Lars Peter Kamolz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University Graz, Auenbruggerplatz 29, 8036 Graz, Austria; (D.P.); (S.P.N.); (L.P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgsellschaft mbH, 8036 Graz, Austria
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Ring A, Goertz O, Al-Benna S, Ottomann C, Langer S, Steinstraesser L, Schmitz I, Tilkorn D. Accelerated Angiogenic Induction and Vascular Integration in a Novel Synthetic Scaffolding Matrix for Tissue Replacement. Int J Artif Organs 2018. [DOI: 10.1177/039139881003301206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Reduced or delayed neovascularization is a major obstacle with regard to tissue-engineered constructs. The aim of this study was to evaluate the early microvascular response to a novel degradable ε-caprolactone terpolymer matrix. Methods ε-caprolactone terpolymer matrices (Suprathel Plus®; Institute of Textile and Process Engineering, Denkendorf, Germany) were implanted into dorsal skinfold chambers of balb/c mice (n=10). Microcirculatory changes were observed by intravital fluorescence microscopy. Scaffolding matrices from PEGT/PBT copolymer were used as controls (n=10). Results The formation of de novo vascular networks within both scaffolding matrices was noted throughout the experiment. A vascular ingrowth of perfused microvessels into the matrices up to 600 μm apart from the edge was noted within 10 days of implantation. The earliest signs of neoangiogenesis were visible in ε-caprolactone terpolymer matrices on day 1. In both scaffolds the new developed vessels extended centripetally from the border of the matrices towards the center and anastomosed to form a perfused microvascular network. There was significantly earlier onset of vascularization, increased vascularized area and higher vessel density in ε-caprolactone terpolymer matrices compared to PEGT/PBT copolymer matrices were observed. Conclusions The scaffolding matrix from ε-caprolactone terpolymer allowed for an earlier and more intense induction of angiogenesis and displayed the tendency to vascularize more rapidly within a shorter period of time after transplantation compared to PEGT/PBT copolymer scaffolds, thus indicating its potential application for tissue engineering purposes.
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Affiliation(s)
- Andrej Ring
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
| | - Ole Goertz
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
| | - Sammy Al-Benna
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
| | - Christian Ottomann
- Section for Plastic Surgery, University Hospital Campus Lübeck, Schleswig-Holstein University, Lübeck - Germany
| | - Stefan Langer
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
| | - Lars Steinstraesser
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
| | - Inge Schmitz
- Institute of Pathology, Ruhr University Bochum, Bochum - Germany
| | - Daniel Tilkorn
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum - Germany
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Fan X, Ren H, Liu P, Wang P, Li H, Yan Y, Lv G. Effects of the surface modification of poly(amino acid)/hydroxyapatite/calcium sulfate biocomposites on the adhesion and proliferation of osteoblast-like cells. J Appl Polym Sci 2015. [DOI: 10.1002/app.42427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Xiaoxia Fan
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
| | - Haohao Ren
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
| | - Pengzheng Liu
- Sichuan National Nano Technology Company; Chengdu 610041 China
| | - Peng Wang
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
| | - Hong Li
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
| | - Yonggang Yan
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
| | - Guoyu Lv
- College of Physical Science and Technology; Sichuan University; Chengdu 610064 China
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Ring A, Tilkorn DJ, Goertz O, Langer S, Schaffran A, Awakowicz P, Hauser J. Surface modification by glow discharge gasplasma treatment improves vascularization of allogenic bone implants. J Orthop Res 2011; 29:1237-44. [PMID: 21381095 DOI: 10.1002/jor.21358] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 12/13/2010] [Indexed: 02/04/2023]
Abstract
Sufficient induction of blood vessel ingrowth decisively influence transplant functionality. In this study, microvascular response to transplants of surface modified bone substitutes were assessed in vivo. The surface modification of allogenic bone substitutes (dehydrated human femoral head) was achieved in a double-conductive low-pressure gasplasma reactor (Ar(2) /O(2) , 13.65 MHz, 1,000 W, 5 Pa). The modified bone substitutes (n = 10) as well as untreated bone substitutes serving as controls (n = 10) were placed into the dorsal skinfold chamber of female balb/c mice (n = 10). Dynamic assessment of microcirculatory parameters was performed using intravital fluorescence microscopy during an implantation period of 10 days. The angiogenic response was found markedly accelerated in gasplasma-treated bone. Compared to untreated implants, the gasplasma-activated bone substitutes showed significantly higher microvascular density on days 5 and 10. The quantification of the microvascular diameters, red blood cell velocity, and microvascular permeability displayed stable perfusion and vascular integrity of the newly developed blood vessels throughout the 10-day observation period. The surface activation via cold low-pressure glow discharge gasplasma supports the vascular integration of allogenic bone by earlier induction of the angiogenesis.
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Affiliation(s)
- Andrej Ring
- Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany.
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Ring A, Tilkorn D, Ottomann C, Geomelas M, Steinstraesser L, Langer S, Goertz O. Intravital monitoring of microcirculatory and angiogenic response to lactocapromer terpolymer matrix in a wound model. Int Wound J 2011; 8:112-7. [PMID: 21306564 DOI: 10.1111/j.1742-481x.2010.00742.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to assess the impact of an epidermal substitute, a lactocapromer terpolymer matrix, on microcirculation in wounds. Lactocapromer terpolymer matrices were placed into the dorsal skinfold chamber of mice (n = 10). Untreated chamber preparations served as controls (n = 10). The microcirculation in tissue adjacent to the implant was observed by intravital fluorescence microscopy. Alongside the stable microhaemodynamics, a strong induction of angiogenesis adjacent to the implants was observed. A progressive increase in the functional vessel density was detected throughout the observation time of 10 days. Additionally, a stable and increasing perfusion within the newly developed vascular network in the outer circumference of the matrix was noted. The lactocapromer terpolymer matrix showed no adverse effect on the microcirculation in the host tissue. In contrast, as detected by intravital microscopy, the biomaterial protected the microcirculation and induced angiogenesis.
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Affiliation(s)
- Andrej Ring
- Department of Plastic and Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.
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Exogenous Nitric Oxide Donation Causes Desensitization of Arteriolar Relaxing Activity In Vivo: An Intravital Analysis in Mice. J Surg Res 2010; 164:169-74. [DOI: 10.1016/j.jss.2009.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Indexed: 11/23/2022]
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Ring A, Langer S, Schaffran A, Stricker I, Awakowicz P, Steinau HU, Hauser J. Enhanced neovascularization of dermis substitutes via low-pressure plasma-mediated surface activation. Burns 2010; 36:1222-7. [PMID: 20510519 DOI: 10.1016/j.burns.2010.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 03/07/2010] [Accepted: 03/09/2010] [Indexed: 01/07/2023]
Abstract
PURPOSE The effect of cold low-pressure plasma treatment on neovascularization of a dermis substitute was evaluated in a mouse model. MATERIAL AND METHODS Collagen-elastin matrices (Matriderm(®)) were used as scaffolds. Low-pressure argon/hydrogene plasma-treated scaffolds were transplanted into the dorsal skinfold chambers of balb/c mice (group 1, n=10). Untreated scaffolds served as controls (group 2, n=10). Intravital fluorescence microscopy was performed within the border zone of the scaffolds on days 1, 5 and 10. Functional vessel density (FVD), vessel diameter, intervascular distance, microvascular permeability, and leukocyte-endothelium interaction were analyzed. RESULTS An increase of FVD associated with a reduction of the intervascular distance was observed. Statistical analysis revealed that the functional vessel density in the border zone of the scaffolds was significantly enhanced in the plasma-treated group compared to controls. For group 1, an increase of FVD from 282±8 cm/cm(2) on days 5 to 315±8 cm/cm(2) on day 10 was observed. Whereas values of 254±7 cm/cm(2) on day 5 and 275±13 cm/cm(2) on day 10 have resulted in group 2 (mean±S.E.M., Student's t-test, p<0.05). CONCLUSION The surface treatment by cold low-pressure plasma intensifies the angiogenesis and accelerates the neovascularization of collagen-elastin matrix.
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Affiliation(s)
- Andrej Ring
- Department of Plastic and Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr University Bochum, Buerkle-de-la-Camp Platz 1, 44789 Bochum, Germany.
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Lemon G, Howard D, Tomlinson MJ, Buttery LD, Rose FRAJ, Waters SL, King JR. Mathematical modelling of tissue-engineered angiogenesis. Math Biosci 2009; 221:101-20. [PMID: 19619562 DOI: 10.1016/j.mbs.2009.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 01/30/2009] [Accepted: 07/09/2009] [Indexed: 10/20/2022]
Abstract
We present a mathematical model for the vascularisation of a porous scaffold following implantation in vivo. The model is given as a set of coupled non-linear ordinary differential equations (ODEs) which describe the evolution in time of the amounts of the different tissue constituents inside the scaffold. Bifurcation analyses reveal how the extent of scaffold vascularisation changes as a function of the parameter values. For example, it is shown how the loss of seeded cells arising from slow infiltration of vascular tissue can be overcome using a prevascularisation strategy consisting of seeding the scaffold with vascular cells. Using certain assumptions it is shown how the system can be simplified to one which is partially tractable and for which some analysis is given. Limited comparison is also given of the model solutions with experimental data from the chick chorioallantoic membrane (CAM) assay.
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Affiliation(s)
- Greg Lemon
- School of Mathematical Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
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Zhang A, Feng Z, Xie Z. Long-term investigation on hydrolytic degradation and morphology of poly(ethylene glycol terephthalate)-b-poly(butylene terephthalate) copolymer films. J Appl Polym Sci 2009. [DOI: 10.1002/app.28948] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ring A, Goertz O, Muhr G, Steinau HU, Langer S. In vivo microvascular response of murine cutaneous muscle to ibuprofen-releasing polyurethane foam. Int Wound J 2008; 5:464-9. [PMID: 18593395 DOI: 10.1111/j.1742-481x.2007.00403.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In view of their pain-relieving effect, the non steroidal anti-inflammatory drugs are more and more used as a pain-reducing component in modern wound dressings. To analyse the effect on new blood vessel growth, implants from Biatain Ibu, a polyurethane foam containing ibuprofen, were inserted into the dorsal skinfold chamber of BALB/c mice. Implants from ibuprofen-free polyurethane foam Biatain served as controls (n = 10 per group). Blood vessel growth and the functional vessel density (FVD) as a parameter for microvascularization of implant's border zone were assessed by intravital fluorescence microscopy (IVFM). IVFM was performed on days 3, 7 and 12 after implantation. Direct comparison showed no significant differences in FVD (mm/mm(2)) for the border zone of the ibuprofen-releasing implants versus controls on day 3 (185.49 +/- 4.75 versus 197.17 +/- 5.21) and day 7 (229.60 +/- 8.53 versus 247.99 +/- 5.39). However, the IVFM showed a significant increased FVD for ibuprofen-releasing implants (301.30 +/- 8.44 versus 279.24 +/- 5.78) on day 12 (P < 0.05). Also, a significant increase of FVD was detected for the ibuprofen-releasing implants throughout the implantation time of 12 days. This study shows that local release of small-dose ibuprofen from a polyurethane dressing does not decrease new blood vessel growth during the implantation time of 12 days. In the end, the microvascularization of implant's border zones in both groups was found comparatively undisturbed.
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Affiliation(s)
- Andrej Ring
- Department of Surgery, Trauma Center, University Hospital Bergmannsheil, Bochum, Germany
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Jiao YP, Cui FZ. Surface modification of polyester biomaterials for tissue engineering. Biomed Mater 2007; 2:R24-37. [DOI: 10.1088/1748-6041/2/4/r02] [Citation(s) in RCA: 198] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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