Development of gelatin flakes, a new type of anti-adhesive material: a preliminary study of in vivo rat adhesion models

Effect of covering with cross-linked gelatin glue on tissue regeneration in a rat lung injury model

OBJECTIVES

Thoracic reintervention is a common treatment; however, preventing adhesion of the lung to the thoracic cavity wall remains a problem. This study aimed to investigate the effect on pleural adhesion of covering the postoperative pleural injury site with cross-linked gelatin glue (gelatin plus glutaraldehyde, hereafter 'gelatin glue') and to evaluate the proliferation of healing cells on gelatin glue.

METHODS

We created a rat incisional lung-wound model and compared the effects of sealing the wound with gelatin glue (group A, n = 5), fibrin glue (group B, n = 5) or fibrin glue with a polyglycolic acid sheet (group C, n = 5). Adhesions were assessed 28 days postoperatively and compared among the groups using the Karacam's scoring method. Lung-wound healing was studied histologically at day 7 postoperatively. Mesothelial cell proliferation was investigated on gelatin and fibrin glues in vitro.

RESULTS

There were no or few adhesions of the chest wall in group A. The adhesion scores (mean ± standard deviation) were 1.2 ± 0.4, 2.6 ± 1.4 and 3.2 ± 1.2 in groups A, B and C, respectively (A vs C, P = 0.0496). During the healing process, the gelatin glue surface was covered by mesothelial-like cells. Proliferation of cultured mesothelial cells was promoted on the gelatin glue compared with the fibrin glue.

CONCLUSIONS

Covering lung wounds with the gelatin glue reduced adhesions and promoted the growth of healing cells compared with the fibrin glue. These findings suggest that the gelatin glue may help prevent adhesions and thus be a therapeutically effective biomaterial in lung surgery.

Antiadhesion effect of the C17 glycerin ester of isoprenoid-type lipid forming a nonlamellar liquid crystal

Postoperative adhesion is a relevant clinical problem that causes a variety of clinical complications after abdominal surgery. The objective of this study is to develop a liquid-type antiadhesion agent and evaluate its efficacy in preventing tissue adhesion in a rat peritoneal adhesion model. The liquid-type agent was prepared by submicron-sized emulsification of C17 glycerin ester (C17GE), squalene, pluronic F127, ethanol, and water with a high-pressure homogenizer. The primary component was C17GE, which is an amphiphilic lipid of one isoprenoid-type hydrophobic chain and can form two phases of self-assembly nonlamellar liquid crystals. The C17GE agent consisted of nanoparticles with an internal inverted hexagonal phase when evaluated by small-angle X-ray scattering (SAXS) and cryo-transmission electron microscopy (cryo-TEM). Upon contact with the biological tissue, this agent formed a thin membrane with a bioadhesive property. After this agent was applied to a sidewall injury of rats, it showed a percentage average of adhesion significantly less than that obtained with the Seprafilm® antiadhesion membrane in a rat model. Additionally, the retention of the agent prolonged at the applied site in the peritoneal cavity of rats. In conclusion, the C17GE agent is promising as an antiadhesion material. STATEMENT OF SIGNIFICANCE: Postoperative adhesion remains a common adverse effect. Although various materials have been investigated, there are few products commercially available to prevent adhesion. For the sheet-type agent, it is inconvenient to be applied through small laparotomy, especially in laparoscopic surgery. Additionally, the liquid-type agent currently used requires a complicated procedure to spray at the targeted site. Our liquid-type antiadhesion agent can form liquid crystals and act as a thin membrane-like physical barrier between the peritoneum and tissues to prevent adhesion. Indeed, the antiadhesion agent used in our present study significantly prevents adhesion compared with the antiadhesion membrane most used clinically. Moreover, our agent is highly stable by itself and easy to use in laparoscopic surgery, thus leading to a promising new candidate as an antiadhesion material.

Prevention of postoperative adhesions by biodegradable cryogels from pectin and chitosan polysaccharides

The main complication that may arise after surgery is the formation of adhesions. The current trend in the prevention of postoperative adhesions is the application of anti-adhesive barrier materials for the separation of wound tissue during the critical period of mesothelial repair and healing. In this work, cryogels based on pectin and chitosan were obtained by the ionic cryotropic gelation method. It was found that the Heracleum L. pectin cryogels are more elastic (73 ± 6 kPa) than the apple pectin cryogels (29 ± 11 kPa). The addition of chitosan with different physical and chemical characteristics did not significantly affect the elasticity of pectin–chitosan cryogels. The greatest swelling ability was achieved during in vivo incubation of Heracleum L. pectin cryogels and Heracleum L. pectin with reacetylated chitosan cryogels (17.1 ± 1.6 and 14.2 ± 2.0 g/g, respectively). It was found that the complete biodegradation of apple pectin cryogels occurred within 24 h of incubation in the rat abdominal cavity. Heracleum L. pectin cryogels were encapsulated in a fibrous capsule and detected in the abdominal cavity after 168 h. Maximum anti-adhesion effect was observed through the use of apple pectin cryogels (0 ± 0.5 score). Significant anti-adhesive effect was also observed through the use of apple pectin–reacetylated chitosan cryogels (1 ± 0.5 score). Due to the high anti-adhesive activity, such cryogels can be recommended for the development of a new barrier material for use in surgery. The potential anti-adhesive mechanism of apple pectin cryogels which may be attributed to a combination of barrier function and bioactivity of cryogels components was discussed.