Comparison of Small-Intestinal Submucosa and Expanded Polytetrafluoroethylene as a Vascular Conduit in the Presence of Gram-Positive Contamination

Shell, Daniel H.; Croce, Martin A.; Cagiannos, Catherine; Jernigan, T Wright; Edwards, Norma M.; Fabian, Timothy C.

doi:10.1097/01.sla.0000165186.79097.6c

Cited by 66 publications

(47 citation statements)

References 38 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12] Such biological scaffolds have been surprisingly resistant to bacterial infection, [13][14][15][16] even in clinical applications that are at high risk for bacterial contamination. [17][18][19][20] Generally, naturally occurring biomaterials such as those composed of purified collagen or intact ECM are more resistant to bacterial infection than synthetic biomaterials.…”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19][20] Generally, naturally occurring biomaterials such as those composed of purified collagen or intact ECM are more resistant to bacterial infection than synthetic biomaterials. [13][14][15][16]21 Porcine-derived ECM composed of small intestinal sub-mucosa (SIS) has been successfully used as a resorbable biological scaffold for tissue-engineering applications in more than 500,000 human patients and has shown resistance to deliberate bacterial infection in preclinical studies. [13][14][15][16] The antibacterial activity associated with the SIS-ECM is not a property of the intact ECM itself, 22 but rather of the degradation products of the ECM.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16]21 Porcine-derived ECM composed of small intestinal sub-mucosa (SIS) has been successfully used as a resorbable biological scaffold for tissue-engineering applications in more than 500,000 human patients and has shown resistance to deliberate bacterial infection in preclinical studies. [13][14][15][16] The antibacterial activity associated with the SIS-ECM is not a property of the intact ECM itself, 22 but rather of the degradation products of the ECM. 23 In vitro studies have shown that acid/heat-digested SIS-ECM and acid/heat-digested urinary bladder submucosa (UBS)-ECM possess antibacterial activity against gram-positive S. aureus and gram-negative E. coli.…”

Section: Introductionmentioning

confidence: 99%

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Antibacterial Activity within Degradation Products of Biological Scaffolds Composed of Extracellular Matrix

Brennan

Reing²,

Chew³

et al. 2006

Tissue Engineering

210

133

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Biological scaffolds composed of extracellular matrix (ECM) have been shown to be resistant to deliberate bacterial contamination in preclinical in vivo studies. The present study evaluated the degradation products resulting from the acid digestion of ECM scaffolds for antibacterial effects against clinical strains of Staphylococcus aureus and Escherichia coli. The ECM scaffolds were derived from porcine urinary bladder (UBM-ECM) and liver (L-ECM). These biological scaffolds were digested with acid at high temperatures, fractionated using ammonium sulfate precipitation, and tested for antibacterial activity in a standardized in vitro assay. Degradation products from both UBM-ECM and L-ECM demonstrated antibacterial activity against both S. aureus and E. coli. Specific ammonium sulfate fractions that showed antimicrobial activity varied for the 2 different ECM scaffold types. The results of this study suggest that several different lowmolecular-weight peptides with antibacterial activity exist within ECM and that these peptides may help explain the resistance to bacterial infection provided by such biological scaffolds.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antibacterial Activity within Degradation Products of Biological Scaffolds Composed of Extracellular Matrix

Brennan

Reing²,

Chew³

et al. 2006

Tissue Engineering

210

133

View full text Add to dashboard Cite

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“…iologic scaffolds composed of extracellular matrix (ECM) can promote the constructive remodeling of injured tissues through mechanisms that include angiogenesis, [1][2][3][4][5] the recruitment of multipotential progenitor cells to the site of tissue reconstruction, [6][7][8][9] the release of antimicrobial peptides, [10][11][12][13][14][15] and activation of the alternative pathway of immunity. [16][17][18][19][20] There is convincing evidence that hostmediated degradation of ECM scaffolds is typically completed within 8-12 weeks and is necessary to realize the full beneficial effects of ECM-mediated tissue remodeling, [21][22][23] but the mechanisms by which such scaffold degradation occurs have been largely ignored.…”

mentioning

confidence: 99%

Macrophage Participation in the Degradation and Remodeling of Extracellular Matrix Scaffolds

Valentin

Stewart‐Akers

Gilbert

et al. 2009

Tissue Engineering Part A

310

254

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Biologic scaffolds composed of extracellular matrix (ECM) are widely used to facilitate remodeling and reconstruction of a variety of tissues in both preclinical animal studies and human clinical applications. The mechanisms by which such scaffolds influence the host tissue response are only partially understood, but it is logical that the mononuclear macrophage cell population plays a central role. The present study evaluated the role of macrophages that derive from peripheral blood in the degradation of ECM scaffolds. An established rat body wall reconstruction model was used to evaluate the degradation of carbodiimide (CDI)-crosslinked scaffolds composed of porcine small intestinal submucosa (SIS), noncrosslinked SIS, and autologous body wall. To assess the role of circulating macrophages in the degradation process, the degradation of each scaffold was assessed with and without macrophage depletion caused by administration of clodronate-containing liposomes. Results showed that peripheral blood monocytes are required for the early and rapid degradation of both SIS scaffolds and autologous body wall, and that CDI crosslinked SIS is resistant to macrophage-mediated degradation.

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“…34 There are numerous, mostly experimental, reports on the application of ECM bioscaffolds in the repair and reconstitution of many soft tissue structures with variable success. Tissues include the lower urinary tract, [35][36][37] laryngeal cartilage, 38 esophagus, 39 abdominal wall, [40][41][42][43][44][45] diaphragm, 46,47 dura mater, 48 blood vessels, [49][50][51] tendons, [52][53][54][55][56] ligaments, 57,58 fascia, 59 menisci, [60][61][62][63] and bone. 64 Both commercially available ECM matrices on the veterinary market are promoted as implantable products to accelerate wound healing in dogs and cats.…”

mentioning

confidence: 99%

Effect of Porcine Small Intestinal Submucosa on Acute Full‐Thickness Wounds in Dogs

et al. 2008

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Objective-To evaluate the effects of porcine small intestinal submucosa (PSIS) on the healing of full-thickness wounds in dogs, specifically the appearance of granulation tissue, percent epithelialization and contraction, histologic variables of inflammation and repair, and aerobic culture results. Study Design-Prospective, controlled, experimental study. Animals-Purpose-bred, female dogs (n ¼ 10). Methods-Wounds were created bilaterally on the trunk; 1 side as a control and 1 treated with PSIS. First appearance of granulation tissue was recorded. Total wound area, open wound area, and epithelialized area were measured at 21 time points-wound contraction and percent epithelialization were calculated. Aerobic cultures were taken at 4 time points and wound biopsies at 8. Histologic features were graded into an Acute Inflammation Score and Repair Score. Results-There was no difference in first appearance of granulation tissue between PSIS-treated and control wounds. Wound contraction was significantly faster in control wounds as was percent epithelialization after day 21. Histologic Acute Inflammation Scores were significantly higher in PSIS-treated wounds compared with control wounds on days 2 and 6. There were no differences in Histologic Repair Scores between PSIS-treated and control wounds or in aerobic culture results. Conclusion-Wounds treated with PSIS contract more slowly, epithelialize less, and have more pronounced acute inflammation after implantation than control wounds. Clinical Relevance-Acute, full-thickness wounds in dogs do not benefit from treatment with PSIS. r

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Comparison of Small-Intestinal Submucosa and Expanded Polytetrafluoroethylene as a Vascular Conduit in the Presence of Gram-Positive Contamination

Abstract: Compared with ePTFE, SIS induces host tissue remodeling, exhibits a decreased neointimal response to infection, and is resistant to bacterial colonization. SIS may provide a superior alternative to ePTFE as a vascular conduit for peripheral vascular surgery.

Cited by 66 publications

References 38 publications

Antibacterial Activity within Degradation Products of Biological Scaffolds Composed of Extracellular Matrix

Antibacterial Activity within Degradation Products of Biological Scaffolds Composed of Extracellular Matrix

Macrophage Participation in the Degradation and Remodeling of Extracellular Matrix Scaffolds

Effect of Porcine Small Intestinal Submucosa on Acute Full‐Thickness Wounds in Dogs

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