Written by: Dr. Sneha Dhanke | Published on: October 08, 2025
BoneFlo® - Regenerative Power from Surgical Residues
Bone regeneration is a complex biological process that depends on the coordinated activity of cells, growth factors, and the local microenvironment. During orthopedic and trauma surgery, much of this regenerative potential is inadvertently lost through routine suction.
Recent advancements demonstrate that surgical site tissue is a rich source of osteogenic components, and this has led to the development of BoneFlo®, a patented suction device designed not just to remove, but to preserve and harness these biologics.
What’s in the surgical site tissue?
Intraoperatively released tissue has been shown to contain:
Cells
Extracellular Vesicles
Bone Chips
Growth Factors
- Mesenchymal stromal cells (MSCs): multipotent cells capable of osteogenic differentiation and superior proliferation compared to bone marrow aspirate. [1]
- Extracellular vesicles (EVs): biologics messengers enriched with osteogenic microRNAs and proteins, stimulating angiogenesis and bone formation [2]
- Bone chips and marrow provide a natural osteoconductive framework [3]
- Growth factors and cytokines, including PDGF, VEGF, TGF-β, and IGF, drive vascularization and osteogenesis. [4], [5], [6]
These components together form the biological basis of regeneration.
How does BoneFlo® work?
BoneFlo® integrates a vacuum filter system into routine suctioning. As the surgeon operates, it:
- collects autologous tissue (bone fragments, stromal cells, growth factors, EVs) in a sterile closed system.
- concentrates these elements without clogging, preserving viability.
- enriches scaffold (β-TCP, collagen membrane, polymer foams) intraoperatively by vacuum-assisted impregnation.
- delivers a biologically active graft back into the defect, ready to promote healing.
This transforms suction devices from a simple tool into a real-time biologization system.
Clinical Relevance [7], [8], [9], [10]
In conditions like avascular necrosis (AVN) or non-unions, local vascularization and regenerative potential are impaired. BoneFlo® addresses these challenges directly:
- Avoids morbidity at the secondary donor site (iliac crest, RIA).
- Reduces surgical time, bleeding, and infection risk.
- Provides a cost-efficient alternative to recombinant growth factors.
- Creates grafts that are alive, bioactive, and osteoinductive at the time of implantation.
Why does this matter to the surgeons?
BoneFlo® allows surgeons to:
- Maximize patient-derived biology.
- Improve scaffold performance with viable cells and growth factors.
- Integrates scaffold performance with cells and growth factors.
- Integrates seamlessly into the routine workflow
- Deliver bone regeneration support even in patients with limited healing potential (elderly, smokers, metabolic disorders).
Conclusion
Bone healing is not only mechanical but also biological. BoneFlo® redefines suction as a therapeutic ally, giving surgeons the ability to capture and reuse the body’s own regenerative power intraoperatively.
[1] Henze K, Herten M, Haversath M, Busch A, Brandau S, Hackel A, Flohé SB, Jäger M. Surgical vacuum filter-derived stromal cells are superior in proliferation to human bone marrow aspirate. Stem Cell Res Ther. 2019;10(1):338. doi:10.1186/s13287-019-1461-0.
[2] Joly L, Tertel T, Sowislok A, Busch A, Giebel B, Jäger M. Extracellular vesicles from surgical site released tissue mirror the progression during osteogenesis of mesenchymal stromal cells. DKOU, Berlin, 2023. doi:10.3205/23dkou359.
[3] Busch, A., Herten, M., Haversath, M., Kaiser, C., Brandau, S., & Jäger, M. (2020). Ceramic scaffolds in a vacuum suction handle for intraoperative stromal cell enrichment. International Journal of Molecular Sciences, 21(17), 6393. https://doi.org/10.3390/ijms21176393
[4] Jäger, M., Busch, A., & Sowislok, A. (2022). Bioactivation of scaffolds in osteonecrosis. Orthopädie, 51(10), 808–814. https://doi.org/10.1007/s00132-022-04303-z
[5] Han, J., Gao, F., Li, Y., et al. (2020). The use of platelet-rich plasma for the treatment of osteonecrosis of the femoral head: a systematic review. BioMed Research International, 2020, 2642439. https://doi.org/10.1155/2020/2642439
[6] Andriolo, L., Merli, G., Tobar, C., et al. (2018). Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis. International Orthopaedics, 42(7), 1689–1704. doi:10.1007/s00264-018-3898-3
[7] Papaeleftheriou, E., Busch, A., Sowislok, A., Haversath, M., & Jäger, M. (2022, September 28). Biologization of bone substitute materials in orthopedic surgery: The BoneFlo+ concept. Poster presented at the 6th ESTROT Congress, Maastricht, Netherlands.
[8] Rehage, E., Sowislok, A., & Jäger, M. (2023). Surgical site-released tissue is potent to generate bone onto β-TCP and PCL-TCP scaffolds in vitro. International Journal of Molecular Sciences, 24(21), 15877. https://doi.org/10.3390/ijms242115877
[9] Groven, R. V. M., Blokhuis, J. T., Poeze, M., van Griensven, M., & Blokhuis, T. J. (2023). Surgical suction filter-derived bone graft displays osteogenic miRNA and mRNA patterns. European Journal of Trauma and Emergency Surgery. https://doi.org/10.1007/s00068-023-02350-5
[10] Blokhuis, J. T., Groven, R. V. M., Geenen, L., Poeze, M., van Griensven, M., & Blokhuis, T. J. (2024, April 28–30). A novel suction device containing a biomaterial combination of collagen and tricalcium phosphate increases the osteogenic capacity of bone marrow material obtained during surgery. Paper presented at the 12th World Biomaterials Congress, Daegu, South Korea.