title: In vivo characterization of the integration and vascularization of a silk-derived surgical scaffold.
abstract: BACKGROUND
  The application of acellular matrices, biomaterials, and polymeric scaffolds in reconstructive surgery facilitates postsurgical tissue remodeling and is increasingly used clinically in order to improve tissue healing and implant coverage. This study presents an in vivo investigation of the integration of the knitted, silk-derived surgical scaffold, SERI(®) with regard to angiogenesis and wound healing.
  
  
  METHODS
  SERI(®) Surgical Scaffold was implanted into a full-thickness skin defect in male C57BL/6J mice (n = 45) via the dorsal skinfold chamber (DSC). Skin tissue samples were collected for histology on days 2, 5, 7, 10, 14, and 21 (n = 5 per time point) post implantation. Immunohistochemistry was performed for various angiogenic and inflammatory markers, as well as collagen deposition (CD31, VEGF, CD3, CD45, Desmin, and Sirius red). Vascular corrosion casting was used to assess the neovasculature within the silk and was visualized with scanning electron microscopy.
  
  
  RESULTS
  We observed both early and late stages of inflammation during the healing process characterized by the infiltration of regenerating tissue by different subsets of leukocytes. Histological analysis displayed capillary-containing granulation tissue with full scaffold integration. In addition, collagen deposition within the scaffold and full skin defect was significantly increased over time. Qualitative analysis of the regenerated vasculature through corrosion casting and scanning electron microscopy revealed a complex, angiogenic network of capillaries originating from the wound bed.
  
  
  CONCLUSIONS
  Based on these findings, SERI(®) displays the potential to be a promising resorbable bioengineered material for use in reconstructive surgery.
authors.affiliation: Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Monika
authors.initials: M
authors.lastname: Kijanska
authors.affiliation: Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Marmaras
authors.affiliation: Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Alicia
authors.initials: A
authors.lastname: Hegglin
authors.affiliation: Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.
authors.forename: Vartan
authors.initials: V
authors.lastname: Kurtcuoglu
authors.affiliation: Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Pietro
authors.initials: P
authors.lastname: Giovanoli
authors.affiliation: Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland. Electronic address: nicole.lindenblatt@usz.ch.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lindenblatt
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D048091:Guided Tissue Regeneration / Q000295:instrumentation*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008855:Microscopy, Electron, Scanning; D018919:Neovascularization, Physiologic; D047011:Silk; D000072836:Surgical Wound / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D054457:Tissue Scaffolds; D014945:Wound Healing
chemical_list: D047011:Silk
keywords: Acellular matrix; Angiogenesis; Scaffold; Silk scaffold; Vascularization; Wound healing