Abstract
Most surgical procedures require using suture materials that are mechanically efficient and accepted by the patient's body. These sutures are essentially composed of synthetic polymers. However, once implanted in patients, they are recognized as foreign bodies and generate chronic inflammation. Thereafter, the patient's immune system will degrade, encapsulate, or even expel the materials. Our innovation, the Cell-Assembled extracellular Matrix (CAM), synthesized from mesenchymal cells, replicates native tissue environments and promotes integration, reducing complications. In a recent study, we introduced CAM-based biological sutures, demonstrating favorable mechanical properties and vascular surgery compatibility. Controlled culture duration tailors CAM for specific applications. Diverse CAM-based suture models were ex vivo tested in animal aorta anastomoses, confirming compatibility. In vivo carotid anastomoses in sheep validated the clinical significance of these innovative sutures. CAM sutures, derived from immunologically favorable allogeneic fibroblast cells, offer high biocompatibility and exhibit superior mechanical properties compared to synthetics by reducing permeability and increasing burst resistance. In vivo testing in sheep underscores clinical applicability, achieving hemostasis and immediate complication prevention. Importantly, CAM-based sutures are compatible with existing vascular surgery techniques, facilitating adoption by surgeons. In conclusion, our findings underscore the effectiveness and clinical significance of these innovative biological sutures.