(175as) Incorporating Biological Factors Using Different Carrier Materials to Accelerate Implant Healing Capacity

Poor wound healing outcomes following trauma, surgery, or disease affects millions of people each year. Strategies that lead to tissue regeneration will need a strong foundation in physiological repair processes to improve clinical performance. Although Medpor implants are an increasingly common material for head and neck reconstruction applications, proper tissue integration continues to be a challenging aspect of patient recovery. Not only is promoting angiogenesis within the entirety of the Medpor implant a challenge itself, but improper blood vessel growth and epithelialization can lead to scarring, vocal changes, and breathing discomfort. Therefore, expediting this process, while simultaneously promoting implant acceptance, would alleviate patient distress and discomfort. In this project, we incorporate different bioactive elements onto Medpor scaffolds to determine which combinations promote angiogenesis and ultimately, airway tissue healing.

Methods

Three different components were investigated: plasma treatment of the Medpor, the incorporation of different bioactive carrier materials within the Medpor, and the effect of incorporating exosomes onto the scaffold. For each treatment group, 3 male C57BL/6 mice were used, and each mouse underwent a minor surgical procedure to place the implant subcutaneously between the shoulder blades for 21 days. Specifically, this project compares plasma treated (PT) versus untreated (UT) Medpor, the use of fibrin glue (FG) versus collagen gel (CG) as a bioactive carrier, and the addition of purified exosomal product (PEP) versus no addition in fibrin glue (FG+Exo) and collagen gel (CG+Exo) implants. H&E staining micrographs and CD31 immunofluorescent staining were quantified to compare extracellular matrix components and angiogenic factor within the different groups.

Results

Macroscopic H&E staining demonstrated tissue integration throughout the Medpor in all treatment groups. Detection of angiogenic factors were significantly higher in PT than UT implants and were highest in the FG+Exo group. However, there were no notable differences in angiogenic markers between PT, CG, or CG+Exo groups. Furthermore, although there was a significant increase in inflammatory markers between UT and PT implants, there was a significant decrease in these same markers in the FG implants compared with all other groups.

Discussion and Conclusion

Medpor can not only be safely used in head and neck reconstruction, but these findings suggest that plasma treating Medpor may promote angiogenesis while incorporating fibrin glue and exosomes can minimize host immune responses. Ultimately, improvements to this commonly used implant can improve both tissue integration and patient outcomes in the long-term.