"The effectiveness of exogenous cellular therapies has been limited by the ability to efficiently and locally deliver cells to a region of interest. We have developed biological sutures, formed from fibrin microthreads, to overcome these delivery issues and demonstrated increased cell engraftment compared to the current gold standard. However, the cell seeding efficiency onto the sutures is low and during implantation cells are subjected to shear forces as the sutures are pulled through the tissue. As a result, cells go unused after seeding and an uneven distribution of cells from the entry point to exit of the suture. By adding cell attachment and adhesion promoters and increasing culture time we proposed to overcome these issues. We have developed a shear loading method to evaluate the changes in cellular adhesion. Either poly-l-lysine or vitronectin was used to coat sutures. Uncoated control and coated sutures were then seeded with 100,000 human mesenchymal stem cells (hMSCs) for 24hrs or control sutures were seeded for 48hrs. An in vitro shear stress model was created by spinning seeded sutures with a centrifuge. Cell number per unit length prior to and post spinning were compared. To compare the effect of modifications on cell morphology cells were qualitatively assessed and nuclear alignment was evaluated as a robust measurement for overall cellular angle. Control sutures were found to have 6,821±739cells/cm prior to spinning, while sutures modified with poly-l-lysine resulted in 4,226±1,003cells/cm and vitronectin had 19,604±1,829cells/cm (p<0.05 vs. control and poly-l-lysine). 48hrs seeding resulted in a cell number to 4,417±2,266 cells/cm. Spinning resulted in relative decreases in cell number for control and coated sutures. Cells remained attached after sutures were spun after increased incubation time. Cells aligned along the long axis of individual microthreads; the alignment on control sutures was significantly different from all modifications. There was no difference in alignment between modifications, although they were significantly different compared to cells grown on topographically flat tissue culture plastic. These results demonstrated increased cell seeding efficiency and cell number for vitronectin coated biological sutures and increased cell adhesion following increased incubation time. The combination of these two modifications may lead to increased quantity and more evenly distributed cells delivered to diseased tissues by increasing initial cell number, increasing cell engraftment, and increased resistance to shear."