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Cui F, Shen S, Ma X, Fan D. Light-Operated Transient Unilateral Adhesive Hydrogel for Comprehensive Prevention of Postoperative Adhesions. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2403626. [PMID: 38924679 DOI: 10.1002/advs.202403626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/03/2024] [Indexed: 06/28/2024]
Abstract
Dislocation of anti-adhesion materials, non-specific tissue adhesion, and the induction of secondary fibrinolysis disorders are the main challenges faced by postoperative anti-adhesion materials. Herein, a self-leveling transient unilateral adhesive hydrogel is custom-designed to conquer these challenges with a theoretically calculated and dual-step tailored gellan gum (GG) as the sole agent. First, the maximum gelation temperature of GG is lowered from 42-25 °C through controlled perturbation of intra- and inter-molecular hydrogen bonds, which is achieved by employing the methacrylic anhydride as a "hydrogen bond's perturbator" to form methacrylate GG (MeGG). Second, the "self-leveling" injectability and wound shape adaptably are endowed by the formation of borate-diol complexed MeGG (BMeGG). Finally, the transient unilateral tissue-adhesive hydrogel (BMeGG-H) barrier is prepared through photo-controlled cross-linking of reactive alkenyl groups. This degradable hydrogel demonstrates favorable rheological properties, light-controlled unilateral adhesion properties, biocompatibility, anti-fibrin adhesion, and anti-cell adhesion properties in vitro. Comprehensive regulation of the fibrinolysis balance toward non-adhesion is conformed in a rat model after intra-abdominal surgery via anti-autoinflammatory response, intestinal wall integrity repair, and Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) balance adjustment. Notably, the 14th day anti-adhesion effective rate is 100%, indicating its significant potential in clinical applications for postoperative anti-adhesion.
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Affiliation(s)
- Furong Cui
- Engineering Research Center of Western Resource Innovation Medicine Green Manufacturing, Ministry of Education, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Shaanxi Key Laboratory of Degradable Biomedical Materials and Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Biotech. & Biomed. Research Institute, Northwest University, Xi'an, 710069, China
| | - Shihong Shen
- Engineering Research Center of Western Resource Innovation Medicine Green Manufacturing, Ministry of Education, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Shaanxi Key Laboratory of Degradable Biomedical Materials and Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Biotech. & Biomed. Research Institute, Northwest University, Xi'an, 710069, China
| | - Xiaoxuan Ma
- Engineering Research Center of Western Resource Innovation Medicine Green Manufacturing, Ministry of Education, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Shaanxi Key Laboratory of Degradable Biomedical Materials and Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Biotech. & Biomed. Research Institute, Northwest University, Xi'an, 710069, China
| | - Daidi Fan
- Engineering Research Center of Western Resource Innovation Medicine Green Manufacturing, Ministry of Education, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Shaanxi Key Laboratory of Degradable Biomedical Materials and Shaanxi R&D Center of Biomaterials and Fermentation Engineering, School of Chemical Engineering, Northwest University, Xi'an, 710069, China
- Biotech. & Biomed. Research Institute, Northwest University, Xi'an, 710069, China
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Yahyazadeh R, Baradaran Rahimi V, Ahmad Mohajeri S, Iranshahy M, Hasanpour M, Askari VR. Intra-peritoneal lavage of Zingiber officinale rhizome and its active constituent gingerol impede inflammation, angiogenesis, and fibrosis following post-operative peritoneal adhesion in male rats. Saudi Pharm J 2024; 32:102092. [PMID: 38737808 PMCID: PMC11087237 DOI: 10.1016/j.jsps.2024.102092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024] Open
Abstract
Post-operative peritoneal adhesions (PA) are a common and important clinical problem. In this study, we focused on the ameliorative efficacy of ginger and gingerol compounds on surgical-induced peritoneal adhesion, and their strategies that disrupted the PA formation pathways to suppress their incidence. First, liquid chromatography-mass spectrometry (LC-MS) was established to separate and identify several chemical groups of ginger rhizome extract. In the next steps, male Wistar albino rats were randomly selected and divided into various groups, namely sham, control, ginger extract (0.6, 1.8, 5 %w/v), and gingerol (0.05, 0.1, 0.3, and 1 %w/v). Finally, we investigated the macroscopic parameters such as wound healing, body weight as well as spleen height and weight. In addition, visual peritoneal adhesion assessment was performed via Nair et al and Adhesion Scoring Scheme. Moreover, the microscopic parameters and biological assessment was performed via and immunoassays. The present findings revealed significant improvement in wound healing and reduction of the adhesion range, as Nair et al. and Adhesion Scoring Scheme scoring, in both the ginger and gingerol groups compared to the PA group (P < 0.05). Whereas, gingerol (0.3 % w/v) was able to increase the body weight in rats (P < 0.0001) at end stage of experiment. Also, inflammation, angiogenesis, and fibrosis were significantly decreased due to the downregulation of interleukin (IL)-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), respectively, in the ginger and gingerol groups compared to the PA group (P < 0.05). In contrast, the levels of IL-10 were increased in the ginger and gingerol groups compared to the control group (P < 0.01). Our results proved that ginger rhizome and gingerol, as novel therapeutic compounds, could be used to prevent PA for their beneficial anti-inflammatory as well as anti-fibrosis properties in clinical trials. However, further clinical studies are required to approve the effectiveness of ginger and gingerol.
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Affiliation(s)
- Roghayeh Yahyazadeh
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vafa Baradaran Rahimi
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ahmad Mohajeri
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Milad Iranshahy
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maede Hasanpour
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Askari
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Wang Q, Du J, Meng J, Yang J, Cao Y, Xiang J, Yu J, Li X, Ding B. Janus Nanofibrous Patch with In Situ Grown Superlubricated Skin for Soft Tissue Repair with Inhibited Postoperative Adhesion. ACS NANO 2024; 18:12341-12354. [PMID: 38695772 DOI: 10.1021/acsnano.4c01370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
The patch with a superlubricated surface shows great potential for the prevention of postoperative adhesion during soft tissue repair. However, the existing patches suffer from the destruction of topography during superlubrication coating and lack of pro-healing capability. Herein, we demonstrate a facile and versatile strategy to develop a Janus nanofibrous patch (J-NFP) with antiadhesion and reactive oxygen species (ROS) scavenging functions. Specifically, sequential electrospinning is performed with initiators and CeO2 nanoparticles (CeNPs) embedded on the different sides, followed by subsurface-initiated atom transfer radical polymerization for grafting zwitterionic polymer brushes, introducing superlubricated skin on the surface of single nanofibers. The poly(sulfobetaine methacrylate) brush-grafted patch retains fibrous topography and shows a coefficient of friction of around 0.12, which is reduced by 77% compared with the pristine fibrous patch. Additionally, a significant reduction in protein, platelet, bacteria, and cell adhesion is observed. More importantly, the CeNPs-embedded patch enables ROS scavenging as well as inhibits pro-inflammatory cytokine secretion and promotes anti-inflammatory cytokine levels. Furthermore, the J-NFP can inhibit tissue adhesion and promote repair of both rat skin wounds and intrauterine injuries. The present strategy for developing the Janus patch exhibits enormous prospects for facilitating soft tissue repair.
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Affiliation(s)
- Qiusheng Wang
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Jingtao Du
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Jinmei Meng
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Jiasheng Yang
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Yannan Cao
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Jiangdong Xiang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Jianyong Yu
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Xiaoran Li
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
| | - Bin Ding
- Innovation Center for Textile Science and Technology, College of Textiles, Donghua University, Shanghai 201620, China
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4
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Zhao B, Zhu P, Zhang H, Gao Y, Zha L, Jin L, Zhang L. Nanofiber Hydrogel Drug Delivery System for Prevention of Postsurgical Intestinal Adhesion. ACS Biomater Sci Eng 2024; 10:3164-3172. [PMID: 38671385 DOI: 10.1021/acsbiomaterials.3c01936] [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: 04/28/2024]
Abstract
Intestinal adhesion is one of the complications that occurs more frequently after abdominal surgery. Postsurgical intestinal adhesion (PIA) can lead to a series of health problems, including abdominal pain, intestinal obstruction, and female infertility. Currently, hydrogels and nanofibrous films as barriers are often used for preventing PIA formation; however, these kinds of materials have their intrinsic disadvantages. Herein, we developed a dual-structure drug delivery patch consisting of poly lactic-co-glycolic acid (PLGA) nanofibers and a chitosan hydrogel (NHP). PLGA nanofibers loaded with deferoxamine mesylate (DFO) were incorporated into the hydrogel; meanwhile, the hydrogel was loaded with anti-inflammatory drug dexamethasone (DXMS). The rapid degradation of the hydrogel facilitated the release of DXMS at the acute inflammatory stage of the early injury and provided effective anti-inflammatory effects for wound sites. Moreover, PLGA composite nanofibers could provide sustained and stable release of DFO for promoting the peritoneal repair by the angiogenesis effects of DFO. The in vivo results indicated that NHP can effectively prevent PIA formation by restraining inflammation and vascularization, promoting peritoneal repair. Therefore, we believe that our NHP has a great potential application in inhibition of PIA.
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Affiliation(s)
- Bei Zhao
- Zhoukou Central Hospital, Zhoukou 466001, China
| | - Panyong Zhu
- Zhoukou Central Hospital, Zhoukou 466001, China
| | | | - Yaoran Gao
- Zhoukou Central Hospital, Zhoukou 466001, China
| | - Ling Zha
- Zhoukou Central Hospital, Zhoukou 466001, China
| | - Lin Jin
- International Joint Research Laboratory for Biomedical Nanomaterials of Henan, Zhoukou Normal University, Zhoukou 466001, P. R. China
| | - Lei Zhang
- Zhoukou Central Hospital, Zhoukou 466001, China
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5
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Liu R, Zhao Z, Yang Q, Chen S, Yan Z, Li X, Liang L, Guo B, Wang B, Zhang H, Yao F, Li J. A Single-Component Janus Zwitterionic Hydrogel Patch with a Bionic Microstructure for Postoperative Adhesion Prevention. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 38669466 DOI: 10.1021/acsami.4c01845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The development of anti-adhesion hydrogels for preventing postoperative adhesions is an ongoing challenge, particularly in achieving a balance between exceptional antifouling properties and effective in situ tissue retention. In this study, we propose a unique approach with the design of a single-component Janus zwitterionic hydrogel patch featuring a bionic microstructure. The Janus patches were prepared through free radical polymerization of sulfobetaine methacrylate with N, N'-methylenebis(2-propenamide) as the cross-linker. The incorporation of hexagonal facets separated by interconnecting grooves on one side imparts durable and reliable in situ retention capabilities to the Janus hydrogel patch when it is applied to traumatized tissues. The opposing flat surface exhibits outstanding resistance to bacteria, proteins, and cell adhesion, due to the superhydrophilicity and excellent antifouling characteristics of zwitterionic polymers. This dual functionality empowers the Janus hydrogel patch to mitigate adhesions between traumatized and surrounding tissues. The hexagonal and groove bionic microstructures facilitate rapid drainage, promoting swift contact with the tissue for increased adhesion strength, while independent hexagonal microfacets enhance the peeling energy. In an in vivo setting, Janus zwitterionic hydrogel patches with surface microstructures form mutually embedded structures with the cecum surface, minimizing the likelihood of slippage and detachment. Remarkably, in vivo experiments involving abdominal wall cecum injuries illustrate the Janus zwitterionic hydrogel patch's superior anti-adhesion effectiveness compared to commercial controls. Thus, the Janus hydrogel patch, distinguished by its bionic microstructure surface, presents substantial potential in the biomedical field for averting postoperative adhesions.
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Affiliation(s)
- Rui Liu
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Zhongming Zhao
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Qi Yang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Shuang Chen
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Zhuojun Yan
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Xiuqiang Li
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Lei Liang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Bingyan Guo
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
| | - Baoqun Wang
- Qingdao Chenland Marine Biological Engineering Company, Ltd., Qingdao 266100, China
| | - Hong Zhang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin 300350, China
| | - Fanglian Yao
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin 300350, China
| | - Junjie Li
- School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, China
- Frontiers Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering, Ministry of Education, Tianjin University, Tianjin 300350, China
- School of Chemistry and Chemical Engineering, Qinghai Minzu University, Xining 810007, Qinghai, China
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Lu W, Wang X, Kong C, Chen S, Hu C, Zhang J. Hemoadhican-Based Bioabsorbable Hydrogel for Preventing Postoperative Adhesions. ACS APPLIED MATERIALS & INTERFACES 2024; 16:17267-17284. [PMID: 38556996 DOI: 10.1021/acsami.4c01088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Postoperative peritoneal adhesions are a prevalent clinical issue following abdominal and pelvic surgery, frequently resulting in heightened personal and societal health burdens. Traditional biomedical barriers offer limited benefits because of practical challenges for doctors and their incompatibility with laparoscopic surgery. Hydrogel materials, represented by hyaluronic acid gels, are receiving increasing attention. However, existing antiadhesive gels still have limited effectiveness or carry the risk of complications in clinical applications. Herein, we developed a novel hydrogel using polysaccharide hemoadhican (HD) as the base material and polyethylene glycol diglycidyl ether (PEGDE) as the cross-linking agent. The HD hydrogels exhibit appropriate mechanical properties, injectability, and excellent cytocompatibility. We demonstrate resistance to protein adsorption and L929 fibroblast cell adhesion to the HD hydrogel. The biodegradability and efficacy against peritoneal adhesion are further evaluated in C57BL/6 mice. Our results suggest a potential strategy for anti-postoperative tissue adhesion barrier biomaterials.
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Affiliation(s)
- Weiling Lu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Xianjin Wang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Changchang Kong
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Shijunyin Chen
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Chengtao Hu
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
| | - Jianfa Zhang
- Center for Molecular Metabolism, Nanjing University of Science & Technology, Nanjing 210094, China
- Key Laboratory of Metabolic Engineering and Biosynthesis Technology, Ministry of Industry and Information Technology, Nanjing 210094, China
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Sun R, Lei L, Ji J, Chen Y, Tian W, Yang F, Huang Q. Designing a bi-layer multifunctional hydrogel patch based on polyvinyl alcohol, quaternized chitosan and gallic acid for abdominal wall defect repair. Int J Biol Macromol 2024; 263:130291. [PMID: 38378119 DOI: 10.1016/j.ijbiomac.2024.130291] [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: 08/23/2023] [Revised: 02/02/2024] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
In abdominal wall defect repair, surgical site infection (SSI) remains the primary cause of failure, while complications like visceral adhesions present significant challenges following patch implantation. We designed a Janus multifunctional hydrogel patch (JMP) with antibacterial, anti-inflammatory, and anti-adhesive properties. The patch comprises two distinct layers: a pro-healing layer and an anti-adhesion layer. The pro-healing layer was created by a simple mixture of polyvinyl alcohol (PVA), quaternized chitosan (QCS), and gallic acid (GA), crosslinked to form PVA/QCS/GA (PQG) hydrogels through GA's self-assembly effect and hydrogen bonding. Additionally, the PVA anti-adhesive layer was constructed using a drying-assisted salting method, providing a smooth and dense physical barrier to prevent visceral adhesion while offering essential mechanical support to the abdominal wall. The hydrogel patch demonstrates widely adjustable mechanical properties, exceptional biocompatibility, and potent antimicrobial properties, along with a sustained and stable release of antioxidants. In rat models of skin and abdominal wall defects, the JMP effectively promoted tissue healing by controlling infection, inhibiting inflammation, stimulating neovascularization, and successfully preventing the formation of visceral adhesions. These compelling results highlight the JMP's potential to improve the success rate of abdominal wall defect repair and reduce surgical complications.
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Affiliation(s)
- Ran Sun
- Research Institute of General Surgery, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Lei Lei
- Affiliated Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Jiamin Ji
- Research Institute of General Surgery, Jinling Hospital, Southeast University, Nanjing, China
| | - Yuan Chen
- Research Institute of General Surgery, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Weiliang Tian
- Research Institute of General Surgery, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Fan Yang
- Research Institute of General Surgery, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Qian Huang
- Research Institute of General Surgery, Affiliated Jinling Hospital, Medical School, Nanjing University, Nanjing, China.
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Zhou M, An X, Liu Z, Chen J. Biosafe Polydopamine-Decorated MnO 2 Nanoparticles with Hemostasis and Antioxidative Properties for Postoperative Adhesion Prevention. ACS Biomater Sci Eng 2024; 10:1031-1039. [PMID: 38215215 DOI: 10.1021/acsbiomaterials.3c01413] [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: 01/14/2024]
Abstract
Surgical bleeding and cumulative oxidative stress are significant factors in the development of postoperative adhesions, which are always associated with adverse patient outcomes. However, effective strategies for adhesion prevention are currently lacking in clinical practice. In this study, we propose a solution using polydopamine-decorated manganese dioxide nanoparticles (MnO2@PDA) with rapid hemostasis and remarkable antioxidant properties to prevent postsurgical adhesion. The PDA modification provides MnO2@PDA with enhanced tissue adhesiveness and hemocompatibility with negligible hemolysis. Furthermore, MnO2@PDA exhibits impressive antioxidant and free radical scavenging properties, protecting cells from the negative effects of oxidative stress. The hemostatic activity of MnO2@PDA is evaluated in a mouse truncated tail model and a liver injury model, with results demonstrating reduced bleeding time and volume. The in vivo test on a mouse cecal abrasion model shows that MnO2@PDA exhibits excellent antiadhesion properties coupled with alleviated inflammation around the damaged tissue. Therefore, MnO2@PDA, which exhibits high biosafety, rapid hemostasis, and beneficial antioxidant capacity, displays exceptional antiadhesion performance, holding great potential for clinical applications to prevent postoperative adhesion.
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Affiliation(s)
- Mengqin Zhou
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225009, P. R. China
- Jiangsu Key Laboratory of Experimental & Translational Noncoding RNA Research, Medical College, Yangzhou University, Yangzhou 225009, P. R. China
| | - Xueying An
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, P. R. China
| | - Zongguang Liu
- College of Physics Science and Technology, Yangzhou University, Yangzhou 225009, P. R. China
- Microelectronics Industry Research Institute, Yangzhou University, Yangzhou 225009, P. R. China
| | - Jianmei Chen
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225009, P. R. China
- Jiangsu Key Laboratory of Experimental & Translational Noncoding RNA Research, Medical College, Yangzhou University, Yangzhou 225009, P. R. China
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Chen J, Tang X, Wang Z, Perez A, Yao B, Huang K, Zhang Y, King MW. Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions. Bioeng Transl Med 2023; 8:e10565. [PMID: 38023705 PMCID: PMC10658569 DOI: 10.1002/btm2.10565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/27/2023] [Accepted: 06/01/2023] [Indexed: 12/01/2023] Open
Abstract
Postsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti-inflammatory and fibrinolytic agents. The Food and Drug Administration (FDA) has approved the use of physical barrier agents, but they have been associated with conflicting clinical studies and controversy in the clinical utilization of anti-adhesion barriers. In this review, we summarize the human anatomy of the peritoneum, the pathophysiology of adhesion formation, the current prevention agents, as well as the current research progress on adhesion prevention. The early cellular events starting with injured mesothelial cells and incorporating macrophage response have recently been found to be associated with adhesion formation. This may provide the key component for developing future adhesion prevention methods. The current use of physical barriers to separate tissues, such as Seprafilm®, composed of hyaluronic acid and carboxymethylcellulose, can only reduce the risk of adhesion formation at the end stage. Other anti-inflammatory or fibrinolytic agents for preventing adhesions have only been studied within the context of current research models, which is limited by the lack of in-vitro model systems as well as in-depth study of in-vivo models to evaluate the efficiency of anti-adhesion agents. In addition, we explore emerging therapies, such as gene therapy and stem cell-based approaches, that may offer new strategies for preventing adhesion formation. In conclusion, anti-adhesion agents represent a promising approach for reducing the burden of adhesion-related complications in surgical patients. Further research is needed to optimize their use and develop new therapies for this challenging clinical problem.
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Affiliation(s)
- Jiahui Chen
- Department of Textile Engineering, Chemistry and ScienceNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Xiaoqi Tang
- Department of Textile Engineering, Chemistry and ScienceNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Ziyu Wang
- Department of Textile Engineering, Chemistry and ScienceNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Arielle Perez
- UNC School of Medicine Department of SurgeryUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Benjamin Yao
- Montefiore Medical Center Department of Obstetrics & Gynecology & Women's Health ServicesMontefiore Medical CenterBronxNew YorkUSA
| | - Ke Huang
- Joint Department of Biomedical EngineeringNorth Carolina State University & University of North Carolina at Chapel HillRaleighNorth CarolinaUSA
- Department of Molecular Biomedical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUnited States
| | - Yang Zhang
- Department of Textile Engineering, Chemistry and ScienceNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Martin W. King
- Department of Textile Engineering, Chemistry and ScienceNorth Carolina State UniversityRaleighNorth CarolinaUSA
- College of Textiles, Donghua UniversityShanghaiSongjiangChina
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Yavuz A, Gok H, Yangi K, Celik SE, Percinoglu G, Goksu K. High-Frequency Bipolar Coagulation Limits Epidural Fibrosis in Lumbar Microdiscectomy. Cureus 2023; 15:e45077. [PMID: 37705564 PMCID: PMC10495867 DOI: 10.7759/cureus.45077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND AND AIM We propose a vast study to examine the effect of high-frequency bipolar coagulation used in the operating room to prevent the development of epidural fibrosis after lumbar microdiscectomy. MATERIALS AND METHODS A total of 1004 participants were divided into two groups: no high-frequency bipolar coagulation (NC group) and high-frequency bipolar coagulation (C group). Postoperative epidural fibrosis, infection rates, reoperation status, and dural injury complications during the operation were recorded. RESULTS Considering the epidural fibrosis rates of the two groups, epidural fibrosis was seen in 10.6% of the patients in the NC group. In contrast, it was seen in only 6.2% of the patients in the C group. CONCLUSION The complication of epidural fibrosis that develops after lumbar microsurgery operations both impairs patient comfort and brings with it the complications of reoperation. After performing hemostasis with bipolar, coagulating the annulus may effectively reduce epidural fibrosis and prevent reoperation.
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Affiliation(s)
- Ahmed Yavuz
- Neurosurgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, TUR
| | - Haydar Gok
- Neurological Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, TUR
| | - Kivanc Yangi
- Neurological Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, TUR
| | - Suat Erol Celik
- Neurological Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, TUR
| | - Gokhan Percinoglu
- Neurological Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, TUR
| | - Kamber Goksu
- Radiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, TUR
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Bordoni B, Escher AR, Girgenti GT. Peritoneal Adhesions in Osteopathic Medicine: Theory, Part 1. Cureus 2023; 15:e42472. [PMID: 37502471 PMCID: PMC10369357 DOI: 10.7759/cureus.42472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 07/29/2023] Open
Abstract
Peritoneal adhesions form as a result of trauma to the abdomen, injuries resulting from surgery, and infections. These tissutal neoformations are innervated and vascularized, and with lymphatic vessels, adherence becomes a new and independent structure, capable of negatively influencing visceral functions. Adherent neogenesis can be asymptomatic or can be a source of pain, limiting the patient's quality of life. Although adhesiolysis remains the elective approach to eliminate adhesions, this therapeutic route prepares the peritoneal anatomical area to recur. The article reviews information on adhesion formation and peritoneal anatomy, probable subjective predispositions, and pathways that carry nociception. The text aims to be a theoretical basis for making new treatment suggestions for non-invasive osteopathic medicine, through a second part will be discussed in another article.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Don Carlo Gnocchi Foundation, Milan, ITA
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Gregory T Girgenti
- Anesthesiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
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