It happened several years ago, my mischievous Chesapeake Bay Retriever, Boone, fell to the temptation that so often happens with retrievers. Before this instant, I had no idea it was even possible to dismantle a Croc. Now, say what you will about the foam loafer, and the looks of which that are highly discerning, but I at the moment of realization, I couldn't help but feel a sense of awe at what my companion made of the dense rubber. Unfortunately, it didn't take long for the Croc to seek revenge.
My dearest friend made a complete recovery. A snip here, a snip there, and he was back to his normal self in several weeks. During surgery, partially because of my insistence, our wonderful surgeon used a BioSIS extracellular matrix graft to wrap the anastomosis site following the foreign body removal. Providing additional strength and support for remodeling, the graft helped prevent dehiscence as well as promote the growth of endothelial lining around the surgical site - preventing the formation of adhesion.
BioSIS, an extracellular matrix technology, is an acellular bioscaffold that focuses on the environment cells need to regenerate rather than the cells themselves. By creating a natural environment that mimics the functionality of damaged tissue, a proper ECM bioscaffold will harness the potential of a patient's native cells to fully repair damaged tissue with four unique benefits:
- Signaling To The Body
- Providing Resistance To Infection
- Enabling Complete Remodeling
- Providing Long Term Strength
1. Signaling To The Body
Just as a patient’s natural environment signal cells to differentiate into site appropriate tissue, an ECM bioscaffold, like BioSIS, will replicate natural movement and send signals to circulating stem cells. These signals of stress and function enable a patient’s stem cells to differentiate into healthy, site-specific tissue. Unlike synthetic materials, or some other biologic grafts, true ECM products communicate with the body, signaling adjacent healthy tissue to grow across and incorporate into the extracellular matrix. The result is completely remodeled, strong, fully vascularized tissue to replace damaged tissue that once existed.
2. Providing Resistance To Infection
For a biomaterial to repair a complex and contaminated tissue defect, it must be able to signal the influx of host defenses to fend off infection. Because BioSIS facilitates angiogenesis and rapidly remodels into vascularized tissue, it allows the patients own defense mechanisms to react and respond to any potential infection. This property of ECM bioscaffolds, is invaluable to veterinarians working hard to manage infection on an injured patient during veterinary gastrointestinal surgery, or corneal tissue repair in dogs or cats.
3. Enabling Complete Remodeling
There are often complications when surgically implanting a synthetic material. A biomaterial, on the other hand, produces a permanent repair without leaving behind foreign material. ECM products facilitate this type of remodeling. Following implantation, the site-specific remodeled tissue displays similar physiologic and morphologic characteristics as the native tissue. During the healing process, the body’s native tissue fully replaces the ECM products – developing into a permanent repair without the long-term presence, or potential complications, of an unnatural material.
4. Providing Long Term Strength
As native cells require distinct molecular and functional signals, proper biomaterials must properly replicate the true functionality to recruit and effectively differentiate stem cells into proper tissue. Though the end objective is to fully restore native, organized tissue without leaving behind any foreign material, the most advanced ECM biological scaffolds, like BioSIS, are remarkably strong and maintain the needed structural support to replicate natural movement and function until the proper tissue has been restored. This functionality of true ECM grafts is critical to the restoration of healthy tissue. As the patient’s cells require proper signaling from the function of the damaged site, it is vital for a biologic graft to function in concert with the natural movements of the body. Immediate functionality is one of the key factors in using biologic grafts to regenerate tissue. Furthermore, proper ECM biomaterials do not degrade or weaken until the bioscaffold is fully populated with native cells.
Time and time again, veterinary surgeons are faced with difficult circumstances involving damaged or complete tissue loss. In my personal case, it was the loss of approximately 14 inches of intestinal tract along with the sinister chunks of dense rubber from within. The field of biological scaffolds, and veterinary regenerative medicine continues to exponentially grow and it is my hope that with the knowledge of these key components, you, the surgeon now have a better understanding of what to look for when using such biological scaffolds during veterinary surgery.