Article
Physiological and pharmacodynamic effects of suture materials on human fibroblasts
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Published: | July 22, 2009 |
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Introduction: The modern medicine is not conceivable without surgical suture materials. But still today the intolerance reactions between these materials and the tissue produce medical problems. Therefore there has been a lot of research in that field of interest. Especially in head and neck surgery, suture materials are increasingly tested in vitro on compatibility with cell cultures. Our study has the aim to resolve, in which way the adherence of fibroblasts differs in divers suture materials. Furthermore the question, if there is a correlation between the adherence and the surface structure, is posed.
Materials and methods: In the present survey normal fibroblast cells (commercially acquired as well as primary cells from subepithelial tissues) were used. For the immunohistochemical characterisation of the primary cells the fibroblast marker vimentin (DAKO) was utilised and the verification of the purity of the primary fibroblasts culture succeeded via CD 68 marker (DAKO). The study includes a total of 37 different surgical suture materials (laminated/unlaminated, non-/absorbable stitches) which were estimated with light- and electron microscopic techniques. Out of this group we used 5 filaments (1 silver fibre, 1 partial absorbable, 1 absorbable and 2 non-absorbable fibres) for tests concerning pharmacodynamic effects (via an analyzing system, developed by Bionas). Finally an EDX-analysis (energy dispersive X-ray spectroscopy-analysis) was realised by a scanning electron microscope on every used suture material.
The above mentioned cell cultures were cultivated in an incubator (37°C, 5% CO2, with water vapour saturated atmosphere) for 10 days. The adherence of the fibroblasts could be obtained and analysed also with light- and electron microscopy. Simultaneously the vitality determination was specified by trypane blue staining. Moreover, the quantitative analysis of the cell proliferation succeeded synchronously.
After the end of the cultivating time the cytoxicity was determined by use of the LDH-test (Roche).
Results: Every filament showed a cell adherence, but a correlation between the different fibres and the cell count could not be observed. That applies for both the commercial and primary cell lines. Furthermore there was no significant difference between the several cytotoxic analyses. The vitality amounted regularly ≥ 98%.
Using the EDX-determination it succeeded to explore the particular chemical composition of the several filaments. In regard to the pharmacodynamic effects (cellular respiration, cellular impedance, acidification) the silver fibre, the SERAPREN- and SERALENE-fibres (non-absorbable filaments) did not exposed an influence on the cell metabolism. However the cell metabolism was significantly influenced by the partially and fully absorbable fibres (Proflex, SERAFAST/Monofast), which was partly reversible.
Discussion: The in-vitro examination of the tissue compatibility of biomaterials is an accepted and valid method, because living cells react very sensitive to foreign materials. Especially in head and neck surgery it is of particular importance to receive information on direct effects of biomaterials on the metabolism and growth behaviour of cells, to gain prospective evidence about the possible tissue reaction in humans.
Aside it is essential for all surgery sections to develop suture materials, which can locally influence the growth behaviour in such a way that they have inhibiting or proliferating effects.
In conclusion our study demonstrates for the first time a complete observation of suture materials concerning three pharmacodynamic parameters, namely cellular respiration, cellular impedance and acidification.