title: Reduction of suture associated inflammation after 28 days using novel biocompatible pseudoprotein poly(ester amide) biomaterials.
abstract: Sutures elicit an inflammatory response, which may impede the healing process and result in wound complications. We recently reported a novel family of biocompatible, biodegradable polymers, amino acid-based poly(ester amide)s (AA-PEA), which we have shown to significantly attenuate the foreign body inflammatory response in vitro. Two types of AA-PEA (Phe-PEA and Arg-Phe-PEA) were used to coat silk or plain-gut sutures, which were implanted in the gluteus muscle of C57BL/6 mice, while the uncoated control sutures were implanted in the contralateral side. After 3, 7, 14, and 28 days the mean area of inflammation surrounding the sutures was compared. Phe-PEA coating of silk sutures significantly decreased inflammation compared with noncoated controls (67.8 ± 17.4% after 3d [p = 0.0014], 51.6 ± 7.2% after 7d [p < 0.001], and 37.3 ± 8.3% after 28d [p = 0.0001]) when assessed via analysis of photomicrographs using digital image software. Phe-PEA coated plain-gut sutures were similarly assessed and demonstrated a significant decrease in the mean area of inflammation across all time points (54.1 ± 8.3% after 3 d, 41.4 ± 3.9% after 7 d, 71.5 ± 8.1% after 14 d, 78.4 ± 8.5%, and after 28 d [all p < 0.0001]). Arg-Phe-PEA coated silk demonstrated significantly less inflammation compared to noncoated controls (61.3 ± 9.4% after 3 d, 44.7 ± 4.7% after 7 d, 19.6 ± 8%, and 38.3 ± 6.8% after 28 d [all p < 0.0001]), as did coated plain-gut (37.4 ± 8.3% after 3 d [p = 0.0004], 55.0 ± 7.8% after 7 d [p < 0.0001], 46.0 ± 4.6% after 14 d [p < 0.0001], and 59.0 ± 7.9% after 28 d [p < 0.0001]). Both Phe-PEA and Arg-Phe-PEA coatings significantly decrease the inflammatory response to sutures in vivo for up to 28 days.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Weill Cornell Medical College, New York.
authors.forename: Karina A
authors.initials: KA
authors.lastname: Hernandez
authors.forename: Rachel Campbell
authors.initials: RC
authors.lastname: Hooper
authors.forename: Tatiana
authors.initials: T
authors.lastname: Boyko
authors.forename: Alyssa R
authors.initials: AR
authors.lastname: Golas
authors.forename: Michel
authors.initials: M
authors.lastname: van Harten
authors.forename: D Q
authors.initials: DQ
authors.lastname: Wu
authors.forename: Andrew
authors.initials: A
authors.lastname: Weinstein
authors.forename: C C
authors.initials: CC
authors.lastname: Chu
authors.forename: Jason A
authors.initials: JA
authors.lastname: Spector
mesh_terms: D000818:Animals; D063566:Biodegradable Plastics / Q000494:pharmacology*; D020099:Coated Materials, Biocompatible / Q000494:pharmacology*; D005549:Foreign-Body Reaction / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D051379:Mice; D011091:Polyesters / Q000494:pharmacology*; D047011:Silk / Q000494:pharmacology*; D013537:Sutures / Q000009:adverse effects*
chemical_list: D063566:Biodegradable Plastics; D020099:Coated Materials, Biocompatible; D011091:Polyesters; D047011:Silk
keywords: coating; foreign body; inflammation; polyesteramide amino acid; suture