Inhibition of Skin Wound Contraction by Nanofibrillar Cellulose Hydrogel

Background: Although wound contraction is an essential part of healing, excessive contraction can compromise healing through induction of scarring and fibrosis. This in turn leads to development of wound contractures that limit elasticity and function. Major research efforts have focused on development of novel therapeutic approaches to gain inhibitory control over wound contraction. Despite these efforts, the need for cost-effective, clinically feasible and effective agents to inhibit wound contraction remains. Methods: In this study, we investigated the effect of nanofibrillar cellulose (NFC) hydrogel on wound contraction both in vitro and in vivo. Two different porcine full thickness wounds (8mm punch-biopsy wounds and 4 x 4cm wounds covered with a 1:3-meshed split thickness skin graft) were treated with or without nanofibrillar cellulose or carboxymethylcellulose (Purilon® hydrogel), which was used as a reference treatment. Wound contraction was observed macroscopically, and histological sections were taken at 14 days' follow-up. Results: Nanofibrillar cellulose hydrogel inhibited 70% of punch-biopsy wound contraction whereas the carboxymethylcellulose hydrogel was ineffective. Importantly, application of nanocellulose on split thickness skin grafts did not inhibit epithelialization of the interstices or cell migration from the graft. Conclusions: Our results, although preliminary, indicate a potential for nanofibrillar cellulose hydrogel as a novel material for controlling excessive wound contraction. Financial disclosure statement: The study was funded by UPM New Business and Development unit. All authors declare no conflicts of interest. Acknowledgements: The skillful technical assistance of Lahja Eurajoki is greatly appreciated. We would also like to thank Veikko Huusko and Olli Valtanen from the animal facility of Helsinki University Central Hospital. In addition, Panu Taipale and Janne Ruokonen from National Nanomicroscopy Center (Aalto University, Finland) are gratefully acknowledged for taking cryo-TEM. Martina Lille from VTT Technical Research Centre of Finland is also thanked for conducting rheology measurements. Corresponding author: Kristo Nuutila, MSc, PhD, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115, knuutila@bwh.harvard.edu ©2017American Society of Plastic Surgeons

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