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Sanjanwala D, Londhe V, Trivedi R, Bonde S, Sawarkar S, Kale V, Patravale V. Polysaccharide-based hydrogels for medical devices, implants and tissue engineering: A review. Int J Biol Macromol 2024; 256:128488. [PMID: 38043653 DOI: 10.1016/j.ijbiomac.2023.128488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/10/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
Hydrogels are highly biocompatible biomaterials composed of crosslinked three-dimensional networks of hydrophilic polymers. Owing to their natural origin, polysaccharide-based hydrogels (PBHs) possess low toxicity, high biocompatibility and demonstrate in vivo biodegradability, making them great candidates for use in various biomedical devices, implants, and tissue engineering. In addition, many polysaccharides also show additional biological activities such as antimicrobial, anticoagulant, antioxidant, immunomodulatory, hemostatic, and anti-inflammatory, which can provide additional therapeutic benefits. The porous nature of PBHs allows for the immobilization of antibodies, aptamers, enzymes and other molecules on their surface, or within their matrix, potentiating their use in biosensor devices. Specific polysaccharides can be used to produce transparent hydrogels, which have been used widely to fabricate ocular implants. The ability of PBHs to encapsulate drugs and other actives has been utilized for making neural implants and coatings for cardiovascular devices (stents, pacemakers and venous catheters) and urinary catheters. Their high water-absorption capacity has been exploited to make superabsorbent diapers and sanitary napkins. The barrier property and mechanical strength of PBHs has been used to develop gels and films as anti-adhesive formulations for the prevention of post-operative adhesion. Finally, by virtue of their ability to mimic various body tissues, they have been explored as scaffolds and bio-inks for tissue engineering of a wide variety of organs. These applications have been described in detail, in this review.
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Affiliation(s)
- Dhruv Sanjanwala
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga (E), Mumbai 400019, Maharashtra, India; Department of Pharmaceutical Sciences, College of Pharmacy, 428 Church Street, University of Michigan, Ann Arbor, MI 48109, United States.
| | - Vaishali Londhe
- SVKM's NMIMS, Shobhaben Pratapbhai College of Pharmacy and Technology Management, V.L. Mehta Road, Vile Parle (W), Mumbai 400056, Maharashtra, India
| | - Rashmi Trivedi
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur 441002, Maharashtra, India
| | - Smita Bonde
- SVKM's NMIMS, School of Pharmacy and Technology Management, Shirpur Campus, Maharashtra, India
| | - Sujata Sawarkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai 400056, Maharashtra, India
| | - Vinita Kale
- Department of Pharmaceutics, Gurunanak College of Pharmacy, Kamptee Road, Nagpur 440026, Maharashtra, India
| | - Vandana Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga (E), Mumbai 400019, Maharashtra, India.
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Nancy Ward C, LeBlanc PE, Edward Burrell R. Effects of composition and pH on the degradation of hyaluronate and carboxymethyl cellulose gels and release of nanocrystalline silver. J Appl Biomater Funct Mater 2024; 22:22808000241257124. [PMID: 38819121 DOI: 10.1177/22808000241257124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Adhesions are fibrous tissue connections which are a common complication of surgical procedures and may be prevented by protecting tissue surfaces and reducing inflammation. The combination of biodegradable polymers and nanocrystalline silver can be used to create an anti-inflammatory gel to be applied during surgery. In this study, sodium hyaluronate and sodium carboxymethyl cellulose were added in concentrations from 0.25% to 1% w/v to aqueous nanocrystalline silver solutions to create viscous gels. Gels were loaded into dialysis cassettes and placed in PBS for 3 days. pH was adjusted using potassium phosphate monobasic and sodium hydroxide. Release of silver into the PBS was measured at several time points. Polymer degradation was compared by measuring the viscosity of the gels before and after the experiment. Gels lost up to 84% of initial viscosity over 3 days and released between 24% and 41% of the added silver. Gels with higher initial viscosity did not have a greater degree of degradation, as measured by percent viscosity reduction, but still resulted in a higher final viscosity. Silver release was not significantly impacted by pH or composition, but still varied between experimental groups.
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Affiliation(s)
- Colleen Nancy Ward
- Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, AB, Canada
| | - Payton E LeBlanc
- Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, AB, Canada
| | - Robert Edward Burrell
- Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, AB, Canada
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Li S, Ren L, Jia D, Yang D, Hao L. Effect of Carboxymethyl Chitin on Capsule Formation around Silicone Implants: An In Vivo and In Vitro Study. Plast Reconstr Surg 2022; 150:815-826. [PMID: 35895017 DOI: 10.1097/prs.0000000000009574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Capsular contracture is a serious complication that occurs after augmentation mammaplasty. The authors previously identified that carboxymethyl chitin had an inhibitory effect on capsule formation. This study was performed to elucidate the possible molecular mechanisms through which carboxymethyl chitin inhibits the formation of a capsule around silicone implants. METHODS In this study, the authors cultured human dermal fibroblasts and treated them with carboxymethyl chitin in vitro. The difference in proliferation between treated and untreated cells was analyzed through the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Protein levels of transforming growth factor beta-1 and alpha smooth muscle actin (α-SMA) were examined by Western blot analysis. Expression levels of type I and type III collagen were checked by enzyme-linked immunosorbent assay. In vivo, silicone implants were placed under the pectoralis muscle in 12 female rabbits. The thickness of the capsule was measured by histologic analysis, and the effect of carboxymethyl chitin on α-SMA, collagen type I and III expression levels was evaluated by real-time polymerase chain reaction analysis, enzyme-linked immunosorbent assay, Western blot, and immunofluorescence analysis. RESULTS In the in vitro study, we confirmed that carboxymethyl chitin inhibited the proliferation of fibroblasts. The protein expression levels of collagen type I, transforming growth factor beta-1, and α-SMA were inhibited by carboxymethyl chitin treatment. In vivo, carboxymethyl chitin treatment reduced capsular thickness and the expression of α-SMA and collagen types I and III in capsules around silicone implants. CONCLUSION The authors' results showed that carboxymethyl chitin could influence capsule formation around silicone implants by inhibiting the fibroblast activity, interrupting fibroblast-to-myofibroblast differentiation, and decreasing collagen synthesis. CLINICAL RELEVANCE STATEMENT Carboxymethyl chitin influence capsule formation around silicone implants. Although more clinical studies are needed to verify the effect of carboxymethyl chitin on capsular contracture, the authors believe that it will play an effective role in the clinical application of reducing the occurrence of capsular contracture.
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Affiliation(s)
- Shasha Li
- From the Plastic and Cosmetic Center, The First Affiliated Hospital of Harbin Medical University; Department of Biochemistry, Qiqihar Medical University; and Teaching and Research Department of Biochemistry and Molecular Biology, Harbin Medical University
| | - Liwen Ren
- From the Plastic and Cosmetic Center, The First Affiliated Hospital of Harbin Medical University; Department of Biochemistry, Qiqihar Medical University; and Teaching and Research Department of Biochemistry and Molecular Biology, Harbin Medical University
| | - Di Jia
- From the Plastic and Cosmetic Center, The First Affiliated Hospital of Harbin Medical University; Department of Biochemistry, Qiqihar Medical University; and Teaching and Research Department of Biochemistry and Molecular Biology, Harbin Medical University
| | - Dan Yang
- From the Plastic and Cosmetic Center, The First Affiliated Hospital of Harbin Medical University; Department of Biochemistry, Qiqihar Medical University; and Teaching and Research Department of Biochemistry and Molecular Biology, Harbin Medical University
| | - Lijun Hao
- From the Plastic and Cosmetic Center, The First Affiliated Hospital of Harbin Medical University; Department of Biochemistry, Qiqihar Medical University; and Teaching and Research Department of Biochemistry and Molecular Biology, Harbin Medical University
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Design and Fabrication of Nanofibrous Dura Mater with Antifibrosis and Neuroprotection Effects on SH-SY5Y Cells. Polymers (Basel) 2022; 14:polym14091882. [PMID: 35567051 PMCID: PMC9099771 DOI: 10.3390/polym14091882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 01/27/2023] Open
Abstract
The development and treatment of some diseases, such as large-area cerebral infarction, cerebral hemorrhage, brain tumor, and craniocerebral trauma, which may involve the injury of the dura mater, elicit the need to repair this membrane by dural grafts. However, common dural grafts tend to result in dural adhesions and scar tissue and have no further neuroprotective effects. In order to reduce or avoid the complications of dural repair, we used PLGA, tetramethylpyrazine, and chitosan as raw materials to prepare a nanofibrous dura mater (NDM) with excellent biocompatibility and adequate mechanical characteristics, which can play a neuroprotective role and have an antifibrotic effect. We fabricated PLGA NDM by electrospinning, and then chitosan was grafted on the nanofibrous dura mater by the EDC-NHS cross-linking method to obtain PLGA/CS NDM. Then, we also prepared PLGA/TMP/CS NDM by coaxial electrospinning. Our study shows that the PLGA/TMP/CS NDM can inhibit the excessive proliferation of fibroblasts, as well as provide a sustained protective effect on the SH-SY5Y cells treated with oxygen–glucose deprivation/reperfusion (OGD/R). In conclusion, our study may provide a new alternative to dural grafts in undesirable cases of dural injuries.
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Fatehi Hassanabad A, Zarzycki AN, Jeon K, Dundas JA, Vasanthan V, Deniset JF, Fedak PWM. Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies. Biomolecules 2021; 11:biom11071027. [PMID: 34356652 PMCID: PMC8301806 DOI: 10.3390/biom11071027] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.
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Affiliation(s)
- Ali Fatehi Hassanabad
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Anna N. Zarzycki
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Kristina Jeon
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Jameson A. Dundas
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Vishnu Vasanthan
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Justin F. Deniset
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Paul W. M. Fedak
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
- Correspondence:
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Zhang W, Xin Y, Yin B, Ye GL, Wang JX, Shen JF, Li L, Yang QH. Synthesis and properties of crosslinked carboxymethyl chitosan and its hemostatic and wound healing effects on liver injury of rats. J Biomater Appl 2019; 34:442-450. [PMID: 31137997 DOI: 10.1177/0885328219852888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Wei Zhang
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Yu Xin
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Bin Yin
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Guan L Ye
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Jun X Wang
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Jian F Shen
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Lei Li
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
| | - Qi H Yang
- College of Fisheries, Guangdong Ocean University, Zhanjiang, China
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Guo L, Qin S. Studies on preparations and properties of drug-eluting embolization microspheres made from oxidated alginate and carboxymethyl chitosan. INT J POLYM MATER PO 2018. [DOI: 10.1080/00914037.2018.1517346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Li Guo
- College of Chemistry and Environmental Engineering, Yangtze University, Jingzhou, P. R. China
| | - Shaoxiong Qin
- College of Chemistry and Environmental Engineering, Yangtze University, Jingzhou, P. R. China
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8
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Shariatinia Z. Carboxymethyl chitosan: Properties and biomedical applications. Int J Biol Macromol 2018; 120:1406-1419. [DOI: 10.1016/j.ijbiomac.2018.09.131] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/07/2018] [Accepted: 09/22/2018] [Indexed: 12/22/2022]
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9
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Xu W, Wang Z, Liu Y, Wang L, Jiang Z, Li T, Zhang W, Liang Y. Carboxymethyl chitosan/gelatin/hyaluronic acid blended-membranes as epithelia transplanting scaffold for corneal wound healing. Carbohydr Polym 2018; 192:240-250. [DOI: 10.1016/j.carbpol.2018.03.033] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/22/2018] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
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10
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Ooi ML, Richter K, Drilling AJ, Thomas N, Prestidge CA, James C, Moratti S, Vreugde S, Psaltis AJ, Wormald PJ. Safety and Efficacy of Topical Chitogel- Deferiprone-Gallium Protoporphyrin in Sheep Model. Front Microbiol 2018; 9:917. [PMID: 29867828 PMCID: PMC5958210 DOI: 10.3389/fmicb.2018.00917] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/20/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives: Increasing antimicrobial resistance has presented new challenges to the treatment of recalcitrant chronic rhinosinusitis fuelling a continuous search for novel antibiofilm agents. This study aimed to assess the safety and efficacy of Chitogel (Chitogel®, Wellington New Zealand) combined with novel antibiofilm agents Deferiprone and Gallium Protoporphyrin (CG-DG) as a topical treatment against S. aureus biofilms in vivo. Methods: To assess safety, 8 sheep were divided into two groups of 7 day treatments (n = 8 sinuses per treatment); (1) Chitogel (CG) with twice daily saline flush, and (2) CG-DG gel with twice daily saline flush. Tissue morphology was analyzed using histology and scanning electron microscopy (SEM). To assess efficacy we used a S. aureus sheep sinusitis model. Fifteen sheep were divided into three groups of 7 day treatments (n = 10 sinuses per treatment); (1) twice daily saline flush (NT), (2) Chitogel (CG) with twice daily saline flush, and (3) CG-DG gel with twice daily saline flush. Biofilm biomass across all groups was compared using LIVE/DEAD BacLight stain and confocal scanning laser microscopy. Results: Safety study showed no cilia denudation on scanning electron microscopy and no change in sinus mucosa histopathology when comparing CG-DG to CG treated sheep. COMSTAT2 assessment of biofilm biomass showed a significant reduction in CG-DG treated sheep compared to NT controls. Conclusion: Results indicate that CG-DG is safe and effective against S. aureus biofilms in a sheep sinusitis model and could represent a viable treatment option in the clinical setting.
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Affiliation(s)
- Mian L Ooi
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia
| | - Katharina Richter
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Biofilm Test Facility, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Amanda J Drilling
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia
| | - Nicky Thomas
- Adelaide Biofilm Test Facility, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.,School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Clive A Prestidge
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Craig James
- Clinpath Laboratories, Adelaide, SA, Australia
| | - Stephen Moratti
- Department of Chemistry, Otago University, Dunedin, New Zealand
| | - Sarah Vreugde
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia
| | - Alkis J Psaltis
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia
| | - Peter-John Wormald
- Department of Surgery- Otolaryngology, Head and Neck Surgery, Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, SA, Australia
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Lutsevich OE, Akimov VP, Shirinsky VG, Bichev AA. [Adhesive disease of the peritoneum: modern view at pathogenesis and treatment]. Khirurgiia (Mosk) 2017:100-108. [PMID: 29076493 DOI: 10.17116/hirurgia201710100-108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- O E Lutsevich
- Eudokimov's Moscow Medical-Stomatological University, Moscow, Russia
| | - V P Akimov
- Mechnikov's North-West State Medical Unversity, Saint-Petersburg, Russia
| | - V G Shirinsky
- Eudokimov's Moscow Medical-Stomatological University, Moscow, Russia
| | - A A Bichev
- Eudokimov's Moscow Medical-Stomatological University, Moscow, Russia
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12
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Polymer materials for prevention of postoperative adhesion. Acta Biomater 2017; 61:21-40. [PMID: 28780432 DOI: 10.1016/j.actbio.2017.08.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 01/23/2023]
Abstract
Postoperative adhesion (POA) is a common complication that often occurs after a variety of surgeries, such as plastic surgery, repair operations of abdominal, pelvic, and tendon, and so forth. Moreover, POA leads to chronic abdominal pain, secondary infertility in women, intestinal obstruction, and other severe complications, which significantly reduce the life quality of patients. In order to prevent the formation of POA, a number of strategies have been developed, among which an emerging method is physical barriers consisting of polymer materials. This review highlights the most commonly used natural and synthetic polymer materials in anti-adhesion physical barriers. The specific features of polymer materials are analyzed and compared, and the possible prospect is also predicted. STATEMENT OF SIGNIFICANCE Postoperative adhesion (POA) is a serious complication accompanied with various surgeries. Polymer material-based physical barriers have attracted a large amount of attention in POA prevention. The polymer barriers can effectively avoid the formation of fibrous tissues among normal organs by reducing the interconnection of injured tissues. In this review, specific features of the natural and synthetic polymer materials for application in POA prevention were presented, and the possible prospects were predicted. All in all, our work can provide inspiration for researchers to choose proper polymer materials for preclinical and even clinical anti-adhesion studies.
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Zahir-Jouzdani F, Mahbod M, Soleimani M, Vakhshiteh F, Arefian E, Shahosseini S, Dinarvand R, Atyabi F. Chitosan and thiolated chitosan: Novel therapeutic approach for preventing corneal haze after chemical injuries. Carbohydr Polym 2017; 179:42-49. [PMID: 29111069 DOI: 10.1016/j.carbpol.2017.09.062] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 01/14/2023]
Abstract
Corneal haze, commonly caused by deep physical and chemical injuries, can greatly impair vision. Growth factors facilitate fibroblast proliferation and differentiation, which leads to haze intensity. In this study, the potential effect of chitosan (CS) and thiolated-chitosan (TCS) nanoparticles and solutions on inhibition of fibroblast proliferation, fibroblast to myofibroblast differentiation, neovascularization, extracellular matrix (ECM) deposition, and pro-fibrotic cytokine expression was examined. Transforming growth factor beta-1 (TGFβ1) was induced by interleukin-6 (IL6) in human corneal fibroblasts and expression levels of TGFβ1, Platelet-derived growth factor (PDGF), α-smooth muscle actins (α-SMA), collagen type I (Col I), fibronectin (Fn) and vascular endothelial growth factor (VEGF) were quantified using qRT-PCR. To assess wound-healing capacity, TCS-treated mice were examined for α-SMA positive cells, collagen deposition, inflammatory cells and neovascularization through pathological immunohistochemistry. The results revealed that CS and TCS could down-regulate the expression levels of TGFβ1 and PDGF comparable to that of TGFβ1 knockdown experiment. However, down-regulation of TGFβ1 was not regulated through miR29b induction. Neovascularization along with α-SMA and ECM deposition were significantly diminished. According to these findings, CS and TCS can be considered as potential anti-fibrotic and anti-angiogenic therapeutics. Furthermore, TCS, thiolated derivative of CS, will increase mucoadhesion of the polymer at the corneal surface which makes the polymer efficient and non-toxic therapeutic approach for corneal injuries.
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Affiliation(s)
- Forouhe Zahir-Jouzdani
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, 14174, Iran; Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Faezeh Vakhshiteh
- Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Arefian
- Noor Ophthalmology Research Center, Noor Eye hospital, Tehran, Iran
| | | | - Rasoul Dinarvand
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, 14174, Iran; Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Atyabi
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, 14174, Iran; Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
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Cao Y, Ding Y, Zhang L, Shi G, Sang X, Ni C. Preparation of surface-modified, micrometer-sized carboxymethyl chitosan drug-loaded microspheres. J Appl Polym Sci 2017. [DOI: 10.1002/app.45731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Yuanlong Cao
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
| | - Yuanyuan Ding
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
| | - Liping Zhang
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
| | - Gang Shi
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
| | - Xinxin Sang
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
| | - Caihua Ni
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering; Jiangnan University; Wuxi 214122 China
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Zhou JC, Zhang JJ, Zhang W, Ke ZY, Zhang B. Efficacy of chitosan dressing on endoscopic sinus surgery: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2017; 274:3269-3274. [PMID: 28456847 DOI: 10.1007/s00405-017-4584-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022]
Abstract
Chitosan dressing might be promising to promote the recovery following endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the influence of chitosan dressing on ESS. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of chitosan dressing on endoscopic sinus surgery were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were synechia and hemostasis. Meta-analysis was performed using random-effect model. Four RCTs involving 268 patients were included in the meta-analysis. Overall following ESS, compared with control intervention, chitosan dressing significantly reduced synechia (RR = 0.25; 95% CI 0.13-0.49; P < 0.0001) and promoted hemostasis (RR = 1.70; 95% CI 1.37-2.11; P < 0.00001), but showed no impact on granulations (RR = 1.18; 95% CI 0.72-1.95; P = 0.52), mucosal edema (RR = 0.88; 95% CI 0.60-1.29; P = 0.51), crusting (RR = 0.85; 95% CI 0.48-1.53; P = 0.60), and infection (RR = 0.88; 95% CI 0.51-1.52; P = 0.64). Compared to control intervention, chitosan dressing could significantly decrease edema and improve hemostasis, but had no effect on granulations, mucosal edema, crusting and infection.
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Affiliation(s)
- Jing-Chun Zhou
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, 518020, China.
| | - Jing-Jing Zhang
- Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Wei Zhang
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, 518020, China
| | - Zhao-Yang Ke
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, 518020, China
| | - Bo Zhang
- Department of Otorhinolaryngology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, 518020, China
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Chung YJ, An SY, Yeon JY, Shim WS, Mo JH. Effect of a Chitosan Gel on Hemostasis and Prevention of Adhesion After Endoscopic Sinus Surgery. Clin Exp Otorhinolaryngol 2016; 9:143-9. [PMID: 27090275 PMCID: PMC4881319 DOI: 10.21053/ceo.2015.00591] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). The former sometimes can be life threatening and the latter is the most common reason requiring revision surgery. This study was designed to evaluate the effect of newly developed chitosan gel (8% carboxymethyl chitosan, Surgi shield) on hemostasis and wound healing after ESS. METHODS A prospective, randomized, double-blind controlled trial was conducted in 33 patients undergoing symmetric ESS. At the conclusion of the operation, Surgi shield was randomly applied on one side of the nasal cavity, with the opposite side acting as control and the bleeding quantity of the surgical field was evaluated every 2 minutes. And then, Merocel was placed in the ethmoidectomized areas of the both sides. Five milliliters of Surgi shield was applied to the Merocel of intervention side and saline was applied to the other side. Merocel in both nasal cavities was removed and 5 mL of Surgi shield was applied again to the intervention side on the second day after surgery. The nasal cavity was examined using a nasal endoscope and the degree of adhesion, crusting, mucosal edema, infection, and granulations were graded at 1, 2, and 4 weeks after surgery. RESULTS Complete hemostasis was rapidly achieved in the Surgi shield applied side compared with the control side at 2, 4, 6, 8, and 10 minutes after application of Surgi shield (P=0.007, P=0.004, P<0.001, P=0.001, and P<0.001, respectively). There were significantly less adhesions on the Surgi shield applied side at postoperative 1, 2, and 4 weeks (P=0.001, P<0.001, and P<0.001, respectively). The degree of mucosal edema, infection, crusting, or granulation formation assessed by the endoscopic features in the Surgi shield applied side was not significantly different from that of the control side (P>0.05). No adverse effects were noted in the patient series. CONCLUSION Surgi shield containing chitosan can be used safely to achieve rapid hemostasis immediately after ESS and to prevent adhesion formation.
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Affiliation(s)
- Young-Jun Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Se-Young An
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Je-Yeob Yeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Woo Sub Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ji-Hun Mo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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Ren C, Zhao D, Zhu L. Use of N,O-carboxymethyl chitosan to prevent postsurgical adhesions in a rabbit double uterine horn model: a randomized controlled design. SCIENCE CHINA-LIFE SCIENCES 2016; 59:504-9. [DOI: 10.1007/s11427-016-5019-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/01/2015] [Indexed: 12/21/2022]
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Abstract
In this study, we synthesized carboxymethyl chitosan-graft-poly(ε-caprolactone) (CMCS-g-PCL) by grafting ε-CL onto the hydroxyl groups of CMCS via ring-opening polymerization. The graft copolymers were characterized by 1H NMR spectroscopy and thermogravimetric analysis (TGA). Then use the graft copolymer to produce the micelle by solvent-evaporation method. The DLS and TEM were utilized to evaluate the particle size and morphology and showed that the micelles were in a well-defined spherical shape with a uniform size distribution. The results indicated that the size of range is below 200 nm and could be used as drug carrier and have better active cellular uptake.
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Beyene RT, Kavalukas SL, Barbul A. Intra-abdominal adhesions: Anatomy, physiology, pathophysiology, and treatment. Curr Probl Surg 2015; 52:271-319. [PMID: 26258583 DOI: 10.1067/j.cpsurg.2015.05.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/12/2015] [Indexed: 12/18/2022]
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Upadhyaya L, Singh J, Agarwal V, Tewari RP. The implications of recent advances in carboxymethyl chitosan based targeted drug delivery and tissue engineering applications. J Control Release 2014; 186:54-87. [DOI: 10.1016/j.jconrel.2014.04.043] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/21/2014] [Accepted: 04/23/2014] [Indexed: 12/11/2022]
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Identification and analysis of an impurity inducing clinical adverse effect in anti-adhesion carboxymethyl chitosan products. J Pharm Biomed Anal 2013; 85:21-7. [DOI: 10.1016/j.jpba.2013.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022]
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Zheng Z, Zhang W, Sun W, Li X, Duan J, Cui J, Feng Z, Mansour HM. Influence of the carboxymethyl chitosan anti-adhesion solution on the TGF-β1 in a postoperative peritoneal adhesion rat. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:2549-2559. [PMID: 23820936 DOI: 10.1007/s10856-013-4981-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 06/10/2013] [Indexed: 06/02/2023]
Abstract
The aim of this paper was to investigate the effect of carboxymethyl chitosan anti-adhesion solution on prevention of postsurgical adhesion. Forty adult male Wistar rats were randomly divided into three groups: 0.9% normal saline solution (group A), hyaluronic acid gels (group B) and carboxymethyl chitosan anti-adhesion solution (group C). The animals were treated with normal saline, hyaluronic acid gels or carboxymethyl chitosan anti-adhesion solution at the time of surgery. After 2 or 3 weeks, the degree of adhesions and histological effects were determined. The adhesions in groups B and C were significantly decreased, and the levels of TGF-β1 and hydroxyproline in group C were significantly lower than that in group A (P < 0.05). The histopathology in group C showed fewer inflammatory cells and fibroblasts. Carboxymethyl chitosan anti-adhesion solution can effectively prevent postoperative adhesion which is a promising drug delivery system in the context of postsurgical anti-adhesion.
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Affiliation(s)
- Zengjuan Zheng
- College of Pharmacy and Biological Science, Weifang Medical University, 7166# Baotong Road, Weifang, 261053, People's Republic of China
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Biomedical applications of carboxymethyl chitosans. Carbohydr Polym 2013; 91:452-66. [DOI: 10.1016/j.carbpol.2012.07.076] [Citation(s) in RCA: 219] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 07/16/2012] [Accepted: 07/29/2012] [Indexed: 01/27/2023]
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Dayton MT, Dempsey DT, Larson GM, Posner AR. New paradigms in the treatment of small bowel obstruction. Curr Probl Surg 2012; 49:642-717. [PMID: 23057861 DOI: 10.1067/j.cpsurg.2012.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Merril T Dayton
- Department of Surgery, SUNY Buffalo, Kaleida Health System, Buffalo, NY, USA
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Alves JR, Lopes LR, Sasasaki T. Perioperative care in an animal model for training in abdominal surgery: is it necessary a preoperative fasting? Acta Cir Bras 2012; 26:541-8. [PMID: 22042121 DOI: 10.1590/s0102-86502011000600022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 07/21/2011] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Demonstrate that the rabbit may be used in the training of surgery, in addition to present its perioperative care. METHODS Thirty two animals, with age and weight, respectively, from 3 to 5.5 months old and 3000 to 4200 grams, were undergone different periods of pre-operative fasting, exclusive intramuscular anesthesia (ketamine+xylazine), laparotomy with total gastrectomy and total splenectomy. It was dosed the pre-operative (initial) and post-surgical (end) serum blood glucose, in addition to quantify the gastric content after the resection of the part. RESULTS The anesthetical-surgical procedure presented a mortality rate of 3.125% (1:32) and a morbidity rate of 6.25% (2:32). It was evidenced an initial mean blood glucose = 199.4 mg/dl and the end = 326.1 mg/dl. In spite of extended fasting (minimum of 2 hours for the absolute fasting and maximum of 8.5 hours for liquids, and 20.5 hours for solids) all animals presented at the end of the surgical procedure any gastric content and a blood glucose increase. Those with fasting for liquids and solids when compared to the quantity of solid gastric content, presented a moderate negative degree of correlation. CONCLUSION The rabbit is a good model to be used in training of surgery, with a low morbi-mortality, able to be anesthetized intramuscularly, with no need of pre-operative fasting and does not present hypoglycemia even with the extended fasting period.
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The effect of a chitosan coating on the adhesive potential and tensile strength of polypropylene meshes. Hernia 2012; 16:709-14. [DOI: 10.1007/s10029-012-0950-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 06/22/2012] [Indexed: 11/25/2022]
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Fang Y, Ni Y, Zhang G, Mao C, Huang X, Shen J. Biocompatibility of CS-PPy nanocomposites and their application to glucose biosensor. Bioelectrochemistry 2012; 88:1-7. [PMID: 22750413 DOI: 10.1016/j.bioelechem.2012.05.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/26/2012] [Accepted: 05/30/2012] [Indexed: 11/15/2022]
Abstract
The intrinsic properties and application potential of nanocolloids are mainly determined by size, shape, composition, and structure. In this case, a novel glucose biosensor was developed by using the chitosan-polypyrrole (CS-PPy) nanocomposites as special modified materials that coating onto the surface of glassy carbon electrode (GCE). The CS-PPy nanocomposites were characterized by transmission electron microscopy (TEM) and scanning electron microscopy (SEM), respectively. Moreover, the interaction of CS-PPy nanocomposites with glucose oxidase (GOD) was also investigated by the combined studies with Fourier transform infrared spectroscopy (FTIR) and circular dichroism spectroscopy (CD). Due to the conductivity of polypyrrole (PPy), good biocompatibility of CS, and advantages of nanoparticles, CS-PPy nanocomposites were chosen and designed to modify the GCE for the retention of GOD's biological activity and the vantage of electron transfer between GOD and electrodes. The GOD biosensor exhibited a fast amperometric response (5s) to glucose, a good linear current-time relation over a wide range of glucose concentrations from 5.00×10(-4) to 1.47×10(-1)M, and a low detection limit of 1.55×10(-5)M. The GOD biosensor modified with CS-PPy nanocomposites will have essential meaning and practical application in future that attributed to the simple method of fabrication and good performance.
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Affiliation(s)
- Yi Fang
- Jiangsu Key Laboratory of Biofunctional Materials, College of Chemistry and Materials Science, Nanjing Normal University, Nanjing 210046, PR China
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Medina JG, Steinke JW, Das S. A chitosan-based sinus sealant for reduction of adhesion formation in rabbit and sheep models. Otolaryngol Head Neck Surg 2012; 147:357-63. [PMID: 22492298 DOI: 10.1177/0194599812443647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Chronic sinusitis is the most prevalent chronic disease in the United States in adults aged 18 to 44 years, with approximately 250,000 operations performed annually. Although often successful, sinus surgery fails in greater than 15% of patients. Adhesion formation is a common complication and cause for subsequent revision surgery. Here, the authors evaluate a sprayable chitosan/starch-based sinus sealant and demonstrate its ability to reduce adhesion formation both in vitro and in 2 animal models. STUDY DESIGN Randomized, controlled, animal trials. SETTING Academic medical center (fibroblast experiments) and animal laboratories (sheep and rabbit studies). SUBJECTS AND METHODS This sinus sealant was applied to human cultured fibroblasts obtained from surgically removed polyps to examine its ability to inhibit fibroblast migration and proliferation. The sinus sealant was applied to New Zealand White rabbits (n = 20) in an established cecal-sidewall abrasion model and to sheep (n = 10) in a sinus surgical adhesion model to examine its ability to reduce adhesion formation. RESULTS This sinus sealant inhibited migration and proliferation of human cultured fibroblasts and reduced the total adhesion score from 4.9 to 0.3 for a total reduction of 94% (95th percentile confidence interval [CI], 78%, 100%; P < .001) in a well-established rabbit cecal-sidewall model commonly used for adhesion testing. Moreover, this sealant reduced adhesion formation from 80% to 10% for a total reduction of 70% (95th percentile CI, 57%, 93%; P = .003) in a sheep sinus adhesion surgical model. CONCLUSION This chitosan-based sealant demonstrates promise for reducing adhesion formation in sinus surgery.
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Affiliation(s)
- Jennifer G Medina
- Biomaterials Team, Research and Development, Medtronic Surgical Technologies, Jacksonville, Florida, USA
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Yeh HY, Lin JC. Surface characterization and in vitro platelet compatibility study of surface sulfonated chitosan membrane with amino group protection–deprotection strategy. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 19:291-310. [DOI: 10.1163/156856208783720985] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Hsi-Yi Yeh
- a Department of Chemical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Jui-Che Lin
- b Department of Chemical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
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Yang Z, Han B, Fu D, Liu W. Acute toxicity of high dosage carboxymethyl chitosan and its effect on the blood parameters in rats. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:457-462. [PMID: 22042463 DOI: 10.1007/s10856-011-4467-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 10/18/2011] [Indexed: 05/31/2023]
Abstract
This experiment was aimed to study whether Carboxymethyl chitosan has acute toxicity and effects on the blood parameters of rats, which were treated with high dosage carboxymethyl chitosan (1350 mg/kg) through a laparotomy. Acute toxicity was first studied and then kinds of blood parameters were detected at different time points after the laparotomy, which contain coagulant parameters (thrombin time, prothrombin time, activated partial thromboplatin time and fibrinogen), anticoagulant parameter (antithrombin III), fibrinolytic parameters (plasminogen and fibrin degradation product) and hemorheology parameters (blood viscosity). Results showed that no acute toxicity was detected and no significant effects were found on the parameters of coagulation, anticoagulation, fibrinolysis or hemorheology of rats after the laparotomy, which indicated that carboxymethyl chitosan has no significant toxicity on the blood system of rats after being absorbed in the abdominal cavity and degraded gradually in the blood. And this study has provided experimental basis for carboxymethyl chitosan to be applied in the field of biomedical materials.
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Affiliation(s)
- Zhao Yang
- College of Marine Life Sciences, Ocean University of China, Qingdao, People's Republic of China
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Antisdel JL, Matijasec JL, Ting JY, Sindwani R. Microporous polysaccharide hemospheres do not increase synechiae after sinus surgery: randomized controlled study. Am J Rhinol Allergy 2011; 25:268-71. [PMID: 21819765 DOI: 10.2500/ajra.2011.25.3619] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Many surgeons use absorbable packing materials after endoscopic sinus surgery (ESS). Despite their popularity, some of these agents have been shown to contribute to synechiae formation. Microporous polysaccharide hemospheres (MPH) is a plant-based hemostatic powder that does not interfere with regenerating sinus mucosa in the animal model. The goal of this study was to examine the impact of MPH on healing and synechiae formation after ESS in human subjects. METHODS A prospective, randomized, controlled, double-blind study was performed. Forty consenting adult patients with chronic sinusitis requiring symmetric ESS were randomized to receive MPH unilaterally at the conclusion of surgery. The opposite side was untreated. Standard postoperative care was performed bilaterally. Outcomes measured included blinded observer ratings for synechiae formation, edema, and infection. Each side was examined endoscopically and scored at postoperative days 7, 14, and 30. RESULTS Twenty men and 20 women with an average age of 48.2 years were included. There were no complications and all patients were discharged home the same day. There was no significant difference in synechiae formation at any point postoperatively. The rate of synechiae formation was determined to be 10% (4/40) on the MPH-treated side versus 7.5% (3/40) on the untreated side (p = 0.7639). In addition, there were no significant differences observed in edema (p = 0.7480) or infection (p = 0.5533). CONCLUSION The use of MPH after sinus surgery does not increase synechiae formation and does not appear to deleteriously affect the healing of postoperative sinus cavities.
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Affiliation(s)
- Jastin L Antisdel
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, Saint Louis, Missouri, USA
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Weber RK. Nasal packing and stenting. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 8:Doc02. [PMID: 22073095 PMCID: PMC3199821 DOI: 10.3205/cto000054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue.
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Affiliation(s)
- Rainer K Weber
- Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, HNO-Klinik, Städtisches Klinikum Karlsruhe, Germany
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Ward BC, Panitch A. Abdominal Adhesions: Current and Novel Therapies. J Surg Res 2011; 165:91-111. [DOI: 10.1016/j.jss.2009.09.015] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 08/17/2009] [Accepted: 09/04/2009] [Indexed: 12/20/2022]
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Zhou J, Lee JM, Jiang P, Henderson S, Lee TD. Reduction in postsurgical adhesion formation after cardiac surgery by application of N,O-carboxymethyl chitosan. J Thorac Cardiovasc Surg 2010; 140:801-6. [DOI: 10.1016/j.jtcvs.2009.11.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 10/17/2009] [Accepted: 11/14/2009] [Indexed: 10/19/2022]
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Lauder CIW, Garcea G, Strickland A, Maddern GJ. Use of a modified chitosan-dextran gel to prevent peritoneal adhesions in a rat model. J Surg Res 2010; 171:877-82. [PMID: 20851417 DOI: 10.1016/j.jss.2010.06.028] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 05/28/2010] [Accepted: 06/28/2010] [Indexed: 11/28/2022]
Abstract
BACKGROUND Intra-abdominal adhesions are a major cause of morbidity and a significant drain on healthcare resources. Numerous anti-adhesion products have reached clinical use but none has been wholly satisfactory. This study examines the application of a modified chitosan-dextran (CD) gel to the intraperitoneal cavity to reduce adhesion formation. This is a unique synthetic gel, its active ingredients being succinyl chitosan and dextran aldehyde. MATERIALS AND METHODS Eighty adult male Wistar albino rats were randomized to undergo surgery alone or to receive CD gel at the time of surgery. Control groups using modified dextran only gel were also included. The surgical procedures comprised of laparotomy and either cecal abrasion or anastomotic simulation by enterotomy of the cecum with primary closure. At postoperative d 21 rats were euthanized by CO2 inhalation, and adhesions graded by an investigator blinded to the treatment groups, using a predetermined adhesion measurement score. RESULTS Adhesions were significantly reduced in the cecal abrasion group with median adhesion scores for the treatment group of 0 versus 3 in the control group (P<0.001, Fisher's exact test). Further reduction in adhesion formation was noted in the enterotomy group with median scores of 2 versus 5 for treatment and control groups respectively (P=0.003, Fisher's exact test). CONCLUSIONS Chitosan-dextran gel appears to significantly reduce the formation of intra-abdominal adhesions without adversely affecting wound healing. This is a noteworthy advancement in the safe prevention of post operative, intra-abdominal adhesions.
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Affiliation(s)
- Chris I W Lauder
- University of Adelaide Discipline of Surgery, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Valentine R, Athanasiadis T, Moratti S, Hanton L, Robinson S, Wormald PJ. The efficacy of a novel chitosan gel on hemostasis and wound healing after endoscopic sinus surgery. Am J Rhinol Allergy 2010; 24:70-5. [PMID: 20109331 DOI: 10.2500/ajra.2010.24.3422] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Postoperative bleeding and adhesion formation are the two most common complications after endoscopic sinus surgery (ESS). Continued bleeding risks airway compromise from the inhalation of blood clots and from the aspiration of blood-stained vomitus. Additionally, adhesion formation is the most common reason for patients requiring revision surgery. This study aimed to determine the efficacy of a novel chitosan/dextran (CD) gel on hemostasis and wound healing after ESS. METHODS A randomized controlled trial was performed involving 40 patients undergoing ESS for chronic rhinosinusitis. Immediately after surgery a baseline Boezaart Surgical Field Grading Scale was taken. Computer randomization was performed with one side receiving CD gel and the other side receiving no treatment (control). Boezaart bleeding scores were then calculated for each side every 2 minutes. Patient's endoscopic features of wound healing were assessed at 2, 6, and 12 weeks after surgery. RESULTS CD gel achieved rapid hemostasis with the mean time to hemostasis at 2 minutes (95% CI, 2-4 minutes) compared with 10 minutes (95% CI, > or =6 minutes) for the control (p < 0.001). There were significantly less adhesions at all time points with CD gel versus control: 2 versus 18 at 2 weeks (p < 0.001), 3 versus 16 at 6 weeks (p < 0.001), and 2 versus 12 at 3 months (p < 0.001). There was no significant difference between CD gel and control with respect to crusting, mucosal edema, infection, or granulation tissue formation. CONCLUSION CD gel is rapidly hemostatic immediately after ESS and prevents adhesion formation, addressing two of the most common complications of sinus surgery.
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Affiliation(s)
- Rowan Valentine
- Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
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Cox ED, Schreiber MA, McManus J, Wade CE, Holcomb JB. New hemostatic agents in the combat setting. Transfusion 2010; 49 Suppl 5:248S-55S. [PMID: 19954487 DOI: 10.1111/j.1537-2995.2008.01988.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Hemorrhage is a leading cause of potentially preventable death in both civilian and military trauma patients. Animal data have shown that hemostatic bandages reduce hemorrhage and improve survival. This article reports recent clinical observations regarding the efficacy and evolution of use of two new hemostatic bandages employed in the global war on terrorism. METHODS We performed a retrospective cohort review of soldiers treated with either the QuikClot or HemCon hemostatic bandages between April and October 2006. Hemostatic dressings were placed on wounds either in the field or at the combat support hospital (CSH). RESULTS During the 6-month study period, 1691 trauma patients were admitted to the CSH. Fifty uses of hemostatic dressings in 44 patients (2.6% of admissions) were identified. Forty patients were treated with HemCon dressings, three patients with QuikClot, and one with both QuikClot and HemCon. Eighteen percent of the dressings were used in the field, predominantly on extremity wounds (7/8). In contrast, most dressings used in the CSH were for truncal wounds (26/36 patients). Hemostatic dressings were applied to extremity wounds in prehospital and hospital settings, either alone or in conjunction with tourniquets. In surviving patients (95%), the treating surgeon determined that the hemorrhage was either stopped or greatly decreased by use of hemostatic dressings. Two of the four patients treated with QuikClot had burns from exothermic reactions, while no adverse reactions were noted with HemCon. CONCLUSIONS Hemostatic agents stop or decrease bleeding. Whereas HemCon appears to be safe, QuikClot may produce superficial burns. These new hemostatic agents have a place in the surgical armamentarium to assist in controlling internal hemorrhage from truncal and pelvic hemorrhage, especially during damage-control surgery.
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Affiliation(s)
- E Darrin Cox
- U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6315, USA
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Paulo NM, de Brito e Silva MS, Moraes AM, Rodrigues AP, de Menezes LB, Miguel MP, de Lima FG, de Morais Faria A, Lima LML. Use of chitosan membrane associated with polypropylene mesh to prevent peritoneal adhesion in rats. J Biomed Mater Res B Appl Biomater 2009; 91:221-7. [PMID: 19399842 DOI: 10.1002/jbm.b.31393] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The correction of wall abdominal defects often requires the use of implants such as polypropylene meshes. In spite of presenting good tissue acceptance, these biomaterials can migrate to adjacent viscera, promote enterocutaneos fistulas, tissue adherence and visceral erosions. In this work, the barrier effect of chitosan films associated with polypropylene meshes on adhesion formation experimentally induced in Wistar rats was evaluated. The animals were divided into two groups with 10 animals each. Animals in the CPP group were implanted with chitosan films associated with polypropylene meshes, whereas the ones in the PP group received only polypropylene meshes. After 8 days, the animals were submitted to euthanasia using CO(2) and a descriptive study focusing adhesion formation, visceral involvement with sutures and mesh peritonization was performed. Also, subimplanted material was collected for histopathology analysis. The results showed that the CPP group presented weak adhesions to the omentum over the stitch knots in eight animals. In all animals, the meshes were peritonized, not allowing their visualization after removing the chitosan films. In the PP group, six animals presented intestinal adhesions to the meshes and, in one of them, hepatic adhesion to the mesh was observed, besides omentum adhesion on more than 50% of the mesh area. The protective effect of chitosan films when sutured over polypropylene meshes, as well as no exacerbation of inflammation associated to the peritoneal lesions was statistically demonstrated. Therefore, chitosan films can indeed minimize the formation of peritoneal adhesions induced by polypropylene meshes in rats.
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Affiliation(s)
- Neusa Margarida Paulo
- Department of Veterinary Medicine, School of Veterinary Medicine, Federal University of Goiás, CEP 74001-970 Goiânia, Goiás, Brazil.
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Zhao L, Sun D, Liu M. Adsorption of lipoproteins with the aid of carboxymethylchitosan mircrospheres crosslinked with poly(ethylene glycol) bisglycidyl ether. Carbohydr Polym 2009. [DOI: 10.1016/j.carbpol.2009.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jiang SJ, Zhou XL, Ni YD, Ru JQ, Du HY, Zheng T, Hu QL. Preventive effects of chemically-modified chitosan film with sodium hyalurate on the ischemia-induced peritoneal adhesion. Shijie Huaren Xiaohua Zazhi 2009; 17:1025-1029. [DOI: 10.11569/wcjd.v17.i10.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To comparatively study the preventive effects of chemically-modified chitosan film with sodium hyalurate on the ischemia-induced peritoneal adhesion in rats.
METHODS: Sixty Sprague-Dawley rats were randomly divided into saline-control group (Group A), chemically-modified chitosan film group (Group B) and sodium hyalurate group (Group C), respectively. The ischemia-induced peritoneal adhesive model was established in the caecums of vermiform processes of the rats, and the ischemia surfaces were correspondingly treated with saline, chemically-modified chitosan film and sodium hyalurate in Group A, B and C. After two and four weeks of the treatments, the abdominal cavities were reopened and the adhesive severity was graded blindly according to the Phillips' method. The caecums of vermiform processes were resected for hydroxyproline (OHP) measurement.
RESULTS: After two and four weeks of the treatments in group B and C, the adhesions were significantly lighter (2 wk: U = 3.000, 8.500, P < 0.001, P = 0.001; 4 wk: U = 2.000, 14.000, P < 0.001, P = 0.003) and the OHP levels were significantly lower (2 wk: 0.193 ± 0.029 mg/mg pr, 0.253 ± 0.028 mg/mg pr vs 0.296 ± 0.031 mg/mg pr, both P < 0.01; 4 wk: 0.179 ± 0.034 mg/mg pr, 0.237 ± 0.035 mg/mg pr vs 0.286 ± 0.036 mg/mg pr, both P < 0.01) than those of Group A, respectively. When group B was compared with group C, the former's adhesions were significantly lighter (P = 0.038, P = 0.015) and the OHP levels were significantly lower (P < 0.001, P = 0.001).
CONCLUSION: The chemically-modified chitosan film is more effective in preventing peritoneal adhesion induced by ischemia than that of sodium hyalurate.
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Oliveira JM, Costa SA, Leonor IB, Malafaya PB, Mano JF, Reis RL. Novel hydroxyapatite/carboxymethylchitosan composite scaffolds prepared through an innovative “autocatalytic” electroless coprecipitation route. J Biomed Mater Res A 2009; 88:470-80. [DOI: 10.1002/jbm.a.31817] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Effects of a novel chitosan gel on mucosal wound healing following endoscopic sinus surgery in a sheep model of chronic rhinosinusitis. Laryngoscope 2008; 118:1088-94. [PMID: 18401274 DOI: 10.1097/mlg.0b013e31816ba576] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Postoperative bleeding and adhesion formation remain the two major problems after endoscopic sinus surgery (ESS). This study investigates the effect on adhesion formation and wound healing in a sheep model of chronic sinusitis of three topical agents: recombinant tissue factor (rTF, Dade Innovin, Marburg, Germany), poly-ethylene glycol (SprayGel, Confluent Surgical, Waltham, MA), and a novel chitosan-dextran derivative gel (CD, Department of Chemistry, University of Otago, Dunedin, New Zealand). METHODS Twenty sheep with chronic sinusitis underwent ESS with standardized mucosal injuries created on the lateral nasal wall and the ethmoid region. Injured areas were divided into four groups, and one of the three agents or control (no treatment) was randomly applied. The presence and severity of adhesions were noted and the healing was evaluated by taking brushings for ciliary beat frequency and biopsies of the injured regions at day 28, 56, 84, and 112 post initial surgery. The biopsy specimens were assessed for re-epithelialisation using light microscopy and scanning electron microscopy for reciliation. The cytobrush specimens assessed cilial function by measuring ciliary beat frequency. RESULTS CD significantly decreased lateral nasal wall and ethmoidal adhesions compared to tissue factor at all time points (5% vs. 25%, and 0 vs. 50%, respectively). There was a noticeable trend toward decreased adhesions on the lateral nasal wall and ethmoids in the SprayGel group (10% and 14%) and the CD group (10% and 0%) compared to controls (15% and 40%). The CD group had a significantly greater percentage of re-epithelialisation at day 28 and day 84 compared to the rTF group (70% vs. 33%, P < .001; 84.5% vs. 61%, P < 0.05). At day 28, the CD group was significantly more ciliated than control (62% vs. 31%, P < .01) and than rTF (62% vs. 23%, P < .001). This difference between CD and rTF reciliation remained significant at day 56 (67% vs. 40%, P < .05). In addition, the mean cilial grade for CD at day 112 was significantly better than control (1.9 vs. 2.7, P < .05). CONCLUSION In the sheep model of chronic sinusitis, CD significantly improves microscopic wound healing and reduces adhesion formation after ESS.
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Hong Y, Fujimoto K, Hashizume R, Guan J, Stankus JJ, Tobita K, Wagner WR. Generating elastic, biodegradable polyurethane/poly(lactide-co-glycolide) fibrous sheets with controlled antibiotic release via two-stream electrospinning. Biomacromolecules 2008; 9:1200-7. [PMID: 18318501 PMCID: PMC2860789 DOI: 10.1021/bm701201w] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Damage control laparotomy is commonly applied to prevent compartment syndrome following trauma but is associated with new risks to the tissue, including infection. To address the need for biomaterials to improve abdominal laparotomy management, we fabricated an elastic, fibrous composite sheet with two distinct submicrometer fiber populations: biodegradable poly(ester urethane) urea (PEUU) and poly(lactide-co-glycolide) (PLGA), where the PLGA was loaded with the antibiotic tetracycline hydrochloride (PLGA-tet). A two-stream electrospinning setup was developed to create a uniform blend of PEUU and PLGA-tet fibers. Composite sheets were flexible with breaking strains exceeding 200%, tensile strengths of 5-7 MPa, and high suture retention capacity. The blending of PEUU fibers markedly reduced the shrinkage ratio observed for PLGA-tet sheets in buffer from 50% to 15%, while imparting elastomeric properties to the composites. Antibacterial activity was maintained for composite sheets following incubation in buffer for 7 days at 37 degrees C. In vivo studies demonstrated prevention of abscess formation in a contaminated rat abdominal wall model with the implanted material. These results demonstrate the benefits derivable from a two-stream electrospinning approach wherein mechanical and controlled-release properties are contributed by independent fiber populations and the applicability of this composite material to abdominal wall closure.
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Affiliation(s)
- Yi Hong
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Kazuro Fujimoto
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Ryotaro Hashizume
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Jianjun Guan
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - John J. Stankus
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Kimimasa Tobita
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - William R. Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
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Reduction in postsurgical adhesion formation after cardiac surgery in a rabbit model using N,O-carboxymethyl chitosan to block cell adherence. J Thorac Cardiovasc Surg 2008; 135:777-83. [DOI: 10.1016/j.jtcvs.2007.09.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Revised: 08/23/2007] [Accepted: 09/19/2007] [Indexed: 11/22/2022]
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Yeo Y, Kohane DS. Polymers in the prevention of peritoneal adhesions. Eur J Pharm Biopharm 2007; 68:57-66. [PMID: 17881201 PMCID: PMC2228410 DOI: 10.1016/j.ejpb.2007.03.027] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Revised: 03/22/2007] [Accepted: 03/22/2007] [Indexed: 11/20/2022]
Abstract
Peritoneal adhesions are serious complications of surgery, and can result in pain, infertility, and potentially lethal bowel obstruction. Pharmacotherapy and barrier devices have reduced adhesion formation to varying degrees in preclinical studies or clinical trials; however, complete prevention of adhesions remains to be accomplished. We and others have hypothesized that the limitations of the two approaches could be overcome by combining their strengths in the context of controlled drug delivery. Here we review the role of polymeric systems in the prevention of peritoneal adhesions, with an emphasis on our recent work in developing and applying polymeric drug delivery systems such as nano- or microparticles, hydrogels, and hybrid systems for peritoneal use.
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Affiliation(s)
- Yoon Yeo
- Department of Chemical Engineering, 77 Massachusetts Avenue, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Daniel S Kohane
- Department of Chemical Engineering, 77 Massachusetts Avenue, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Laboratory for Biomaterials and Drug Delivery, Bartlett Extension 413, Division of Pediatric Intensive Care, Massachusetts General Hospital, 55 Fruit St. Boston, MA 02114, USA
- * To whom correspondence should be addressed: Phone: (617) 724-4380 FAX: (617) 724-4391
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Zhou XL, Chen SW, Liao GD, Shen ZJ, Zhang ZL, Sun L, Yu YJ, Hu QL, Jin XD. Preventive effect of gelatinizedly-modified chitosan film on peritoneal adhesion of different types. World J Gastroenterol 2007; 13:1262-7. [PMID: 17451211 PMCID: PMC4147005 DOI: 10.3748/wjg.v13.i8.1262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To comparatively study the preventive effect of gelatinizedly-modified chitosan film on peritoneal adhesions induced by four different factors in rats.
METHODS: Chitosan was chemically modified by gelatinization, and made into films of 60 μm in thickness, and sterilized. Two hundred Sprague-Dawley rats were randomly divided into five groups, Sham-operation group (group A), wound-induced adhesion group (group B), purified talc-induced adhesion group (group C), vascular ligation-induced adhesion group (group D), and infection-induced adhesion group (group E), respectively. In each group, the rats were treated with different adhesion-inducing methods at the cecum of vermiform processes and then were divided into control and experimental subgroups. Serous membrane surface of vermiform processes were covered with the films in the experimental subgroups, and no films were used in the control subgroups. After 2 and 4 wk of treatments, the abdominal cavities were reopened and the adhesive severity was graded blindly according to Bhatia’s method. The cecum of vermiform processes were resected for hydroxyproline (OHP) measurement and pathological examination.
RESULTS: Adhesion severity and OHP level: After 2 and 4 wk of the treatments, in the experimental subgroups, the adhesions were significantly lighter and the OHP levels were significantly lower than those of the control subgroups in group B (2 wk: 0.199 ± 0.026 vs 0.285 ± 0.041 μg/mg pr, P < 0.001; 4 wk: 0.183 ± 0.034 vs 0.276 ± 0.03 μg/mg pr, P < 0.001), D (2 wk: 0.216 ± 0.036 vs 0.274 ± 0.040 μg/mg pr, P = 0.004; 4 wk: 0.211 ± 0.044 vs 0.281 ± 0.047 μg/mg pr, P = 0.003) and E (2 wk: 0.259 ± 0.039 vs 0.371 ± 0.040 μg/mg pr, P < 0.001; 4 wk: 0.242 ± 0.045 vs 0.355 ± 0.029 μg/mg pr, P < 0.001), but there were no significant differences in groups A (2wk: 0.141 ± 0.028 vs 0.137 ± 0.026 μg/mg pr, P = 0.737; 4 wk: 0.132 ± 0.031 vs 0.150 ± 0.035 μg/mg pr, P = 0.225) and C (2 wk: 0.395 ± 0.044 vs 0.378 ± 0.043 μg/mg pr, P = 0.387; 4 wk: 0.370 ± 0.032 vs 0.367 ± 0.041 μg/mg pr, P = 0.853); Pathological changes: In group B, the main pathological changes were fibroplasias in the treated serous membrane surface and in group D, the fibroplasia was shown in the whole layer of the vermiform processes. In group E, the main pathological changes were acute and chronic suppurative inflammatory reactions. These changes were lighter in the experimental subgroups than those in the control subgroups in the three groups. In group C, the main changes were foreign body giant cell and granuloma reactions and fibroplasias in different degrees, with no apparent differences between the experimental and control subgroups.
CONCLUSION: The gelatinizedly-modified chitosan film is effective on preventing peritoneal adhesions induced by wound, ischemia and infection, but the effect is not apparent in foreign body-induced adhesion.
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Affiliation(s)
- Xie-Lai Zhou
- Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Qin Y, Yuan M, Li L, Guo S, Yuan M, Li W, Xue J. Use of polylactic acid/polytrimethylene carbonate blends membrane to prevent postoperative adhesions. J Biomed Mater Res B Appl Biomater 2006; 79:312-9. [PMID: 16637029 DOI: 10.1002/jbm.b.30544] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of the study was to evaluate the effect of a novel biodegradable membrane on the prevention of postoperative adhesion formation. The membrane was prepared by blending 50% PLA (polylactic acid) with 50% PTMC (polytrimethylene carbonate). The prepared blends polymer membrane was more flexible than pure PLA membrane, as measured by glass-transition temperature and tensile study. Cytotoxicity study revealed that PLA/PTMC blends membrane showed good biocompatibility. The membrane elicited slight tissue reaction based on the results of histological study. Thirty adult Japanese rabbits were used for the intestine adhesion model. The treatment group had PLA/PTMC membrane, the control group had chitosan, and the blank control group was not operated. The animals were housed for two weeks and sacrificed to investigate adhesion of intestine. Compared with the blank control group, the treatment group and the control group lowered the extent of adhesions (p < 0.01), but the treatment group was better than the control group (p < 0.05). The in-vivo studies confirmed that PLA/PTMC blends membrane could prevent postoperative adhesions.
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Affiliation(s)
- Yuyue Qin
- College of Light Industry and Food Science, South China University of Technology, Guangzhou 510640, People's Republic of China.
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Schneider A, Bennek J, Olsen KØ, Weiss J, Schmidt W, Rolle U. Experimental study evaluating the effect of a barrier method on postoperative intraabdominal adhesions. Dig Dis Sci 2006; 51:566-70. [PMID: 16614968 DOI: 10.1007/s10620-006-3171-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Accepted: 06/01/2005] [Indexed: 12/09/2022]
Abstract
The purpose of this animal study was to determine if tissue glue-coated collagen sponge is an effective barrier method to prevent localized adhesions in a modified rabbit sidewall model. Rabbits were divided into two groups and underwent laparotomy with subsequent creation of a cecal wound according to the rabbit sidewall model. Rabbits of group I (treatment group; n = 10) were treated with a TachoComb H patch placed on the defect, whereas group II animals (control group; n = 6) did not receive further treatment. All animals were sacrificed 2 weeks postoperatively and adhesions were evaluated using special adhesion score. A further six rabbits underwent TachoComb H application at the cecum to investigate the histological changes during a course of 12 weeks. The average adhesion scores were significantly (P < 0.05) reduced in the treatment group compared to the controls. Histologically the TachoComb H patch was surrounded by granulation tissue without signs of infection. Tissue glue-coated collagen sponge (TachoComb H) is effective to prevent localized intraabdominal adhesions in the modified rabbit sidewall model.
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Affiliation(s)
- Axel Schneider
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
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