A new anti-adhesion film synthesized from polygalacturonic acid with 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide crosslinker

An Antibacterial and Antiadhesion In Situ Forming Hydrogel with Sol-Spray System for Noncompressible Hemostasis

Noncompressible hemorrhage is a major cause of posttrauma death and occupies the leading position among potentially preventable trauma-associated deaths. Recently, multiple studies have shown that strongly adhesive materials can serve as hemostatic materials for noncompressible hemorrhage. However, the risk of severe tissue adhesion limits the use of adhesive hydrogels as hemostatic materials. Here, we report a promising material system comprising an injectable sol and liquid spray as a potential solution. Injectable sol is mainly composed of gelatin (GEL) and sodium alginate (SA), which possess hemostasis and adhesive properties. The liquid spray component, a mixture of tannic acid (TA) and calcium chloride (CaCl₂), rapidly forms an antibacterial, antiadhesive and smooth film structure upon contact with the sol. In vitro and in vivo experiments demonstrated the bioabsorbable, biocompatible, antibacterial, and antiadhesion properties of the in situ forming hydrogel with a sol-spray system. Importantly, the addition of tranexamic acid (TXA) enhanced hemostatic performance in noncompressible areas and in deep wound hemorrhage. Our study offers a new multifunctional hydrogel system to achieve noncompressible hemostasis.

Biocompatible poly(galacturonic acid) micro/nanogels with controllable degradation via tunable chemical crosslinking

Here, one-pot labor-less preparation of two different polygalacturonic acid (PGA) micro/nanogel formulations, PGA-1 and PGA-2, by respectively crosslinking the PGA chains with divinyl sulfone (DVS) and trimethylolpropane triglycidyl ether (TMPGDE) were reported. Various crosslinker ratios, 2.5, 10, 50, and 100% were used for both crosslinkers to demonstrate the tunability of their degradation properties. The PGA micro/nanogels were found spherical-shaped porous particles in 0.5-5.0 μm size range by SEM. The hydrolytic degradation and stability of PGA micro/nanogels in pH 1.0, 7.4, and 9.0 buffer solutions can be controlled by changing the degree of crosslinking. Accordingly, 32 ± 8% and 36 ± 2% weight losses were attained for PGA-1-10% and PGA-2-10% micro/nanogels at pH 1, respectively, and 46 ± 6%, and 68 ± 6% degradations were determined at pH 7.4 within 4 weeks. However, no degradation was observed for both PGA-based micro/nanogel formulations prepared at 25% and 100% crosslinker ratios at all pH conditions. All PGA-based micro/nanogels were totally degraded within 7-10 days at pH 9.0. In the presence of pectinase and amyloglucosidase enzymes, all formulations of PGA micro/nanogels showed more than 80% degradation within 12 h. Furthermore, both PGA formulations showed no significant cytotoxicity against L929 fibroblast cells with 90% and above cell viability up to 250 mg/mL concentrations.

Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies

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.

Effect of Gellan Gum/Tuna Skin Film in Guided Bone Regeneration in Artificial Bone Defect in Rabbit Calvaria

It is necessary to prevent the invasion of soft tissue into bone defects for successful outcomes in guided bone regeneration (GBR). For this reason, many materials are used as protective barriers to bone defects. In this study, a gellan gum/tuna skin gelatin (GEL/TSG) film was prepared, and its effectiveness in bone regeneration was evaluated. The film exhibited average cell viability in vitro. Experimental bone defects were prepared in rabbit calvaria, and a bone graft procedure with beta-tricalcium phosphate was done. The film was used as a membrane of GBR and compared with results using a commercial collagen membrane. Grafted material did not show dispersion outside of bone defects and the film did not collapse into the bone defect. New bone formation was comparable to that using the collagen membrane. These results suggest that the GEL/TSG film could be used as a membrane for GBR.

Stabilized Loading of Hyaluronic Acid-Containing Hydrogels into Magnesium-Based Cannulated Screws

Cannulated screws have a structure for inserting a guide wire inside them to effectively correct complicated fractures. Magnesium, an absorbable metal used to manufacture cannulated screws, may decompose in the body after a certain period of implantation. The hydrogel formed by hyaluronic acid (HA) and polygalacturonic acid (PGA) has been used into Mg-based cannulated screws to prevent bone resorption owing to the rapid corrosion of Mg with unfavorable mechanical properties and a high ambient pH. In addition, Ca ions were added to the gel for cross-linking the carboxyl groups to modify the gelation rate and physical properties of the gel. The developed hydrogels were injected into the Mg-based cannulated screws, after which they released HA and Ca. The possibility of the application of this system as a cannulated screw was evaluated based on the corrosion resistance, gel degradation rate, HA release, toxicity toward osteocytes, and experiments involving the implantation of the screws into the femurs of rats. Ca ions first bound to PGA and delayed the gelation time and dissolution rate. However, they interfered with HA binding and increased the elution of HA at the beginning of gel degradation. Ca(NO₃)₂ concentrations higher than 0.01 M and low pH environments inhibited osteoblast differentiation and proliferation, owing to the elution of HA from the hydrogel. On the other hand, when the HA hydrogel with a proper amount of Ca was inserted into a magnesium screw, the degradation of Mg was delayed, and the presence of the gel contributed to new bone formation and osteocyte expansion.

Antioxidant pectin enriched fractions obtained from discarded carrots (Daucus carota L.) by ultrasound-enzyme assisted extraction

Carrot residues were upgraded as pectin-enriched fractions (PEFs) useful for functional food formulation due to co-extracted antioxidants (α- and β-carotenes, lutein, α-tocopherol), and gelling effect. High power ultrasound (US)-enzyme assisted extraction was applied for efficiency and sustainability. Carrot powder (CP) in citrate-buffer (pH 5.20) was submitted to US-pretreatment (12.27 W/cm²: 20 kHz, 80% amplitude, 20 min) and a subsequent digestion (5 h-40 °C) without or with hemicellulase or cellulase. US-hemicellulase led to the highest PEF yield (27.1%), and extracted almost the whole pectin content of CP. US-pretreatment increased the extraction yield of all PEFs, but the existence of an additional positive effect of the following step depended on the enzyme used. PEFs contained 40-47% of UA with low DM (24-49.9%), and co-extracted antioxidants. US decreased the antioxidant contents, DM, and molecular weight, but allowed obtaining calcium crosslinked true gels, also with higher elastic modulus than non-US-extracted PEFs, being promising as food additives.

Solution properties and electrospinning of poly(galacturonic acid) nanofibers

Poly(galacturonic acid) (PGuA) is an important natural biopolymer, however its potential has not been realized due to its anionic nature and rigid structure, which limits its processability into fine films and fibres. This study aims at modifying the solution properties of PGuA in alkaline medium (aq. sodium hydroxide) to enable their conversion into electrospun nanofibers. Addition of anionic surfactants was found to play an important role in individualizing the PGuA chains that lead to formation of small spindle shaped fibers of length ranging from 2 to 10 μm and diameter from 287 to 997 nm. However, continuous fibers were not formed even at concentrations higher than the critical concentration. Addition of small amount (10-30%) of high molecular weight PVA resulted in formation of continuous fibers. Correlation of fiber diameters of PGuA/PVA with the rheological properties suggested a strong dependence of diameter with the elasticity of the blend solutions. Such PGuA based fibers may be utilized in various biomedical applications.

Self-Lubricanting Slippery Surface with Wettability Gradients for Anti-Sticking of Electrosurgical Scalpel

Soft tissue sticking on electrosurgical scalpels in minimally invasive surgery can increase the difficulty of operation and easily lead to medical malpractice. It is significant to develop new methods for anti-sticking of soft tissue on electrosurgical scalpels. Based on the characteristics of biomimetic ultra-slippery surface, a self-lubricating slippery surface with wettability gradients on electrosurgical scalpel was designed and fabricated. Non-uniformly distributed cylindrical micro pillars, which constitute the wettability gradients, were prepared by an electrolytic etching process and the theoretic of the spontaneous liquid spreading process was analyzed. The silicophilic property of wettability gradients surface was modified by octadecyltrichlorosilane (OTS) self-assembling coat with biocompatible liquid lubricant dimethyl silicone oil. The contact angle of gradient’s surface at different temperatures was measured. The transportation behaviors of both water and dimethyl silicone oil on the wettability gradient’s surface were investigated; the results illustrate that the wettability gradient’s slippery surface can successfully self-lubricate from regions with low pillar density to regions with high pillar density, ascribed to the unbalanced Young’s force. The anti-sticking capability of the electrosurgical scalpel with self-lubricating slippery surface was tested. Both the adhesion force and adhesion mass under different cycles were calculated. The results suggest that the as-prepared slippery surface has excellent anti-sticking ability associated with better durability.

Transglutaminase-catalyzed preparation of crosslinked carboxymethyl chitosan/carboxymethyl cellulose/collagen composite membrane for postsurgical peritoneal adhesion prevention

Peritoneal adhesion is a general complication following pelvic and abdominal surgery, which may lead to chronic abdominal pain, bowel obstruction, organ injury, and female infertility. Biodegradable polymer membranes have been suggested as physical barriers to prevent peritoneum adhesion. In this work, a transglutaminase (TGase)-catalyzed crosslinked carboxymethyl chitosan/carboxymethyl cellulose/collagen (CMCS/CMCL/COL) composite anti-adhesion membrane with various proportions of CMCS, CMCL, and COL (40/40/20, 35/35/30, 25/25/50) was developed. After crosslinking by TGase, the composite anti-adhesion membranes shown enhanced mechanical properties and improved biodegradability. Meanwhile, the high cytocompatibility of anti-adhesion membranes was proved by in vitro cell culture study. Moreover, the anti-adhesion membrane with the proportion of 25/25/50 was implanted between the artificially defected cecum and peritoneal wall in rats and following by general observation, histological examination, and inflammatory factors assay. The results indicated that the anti-adhesion membrane can significantly prevent peritoneal adhesion with negligible immunogenicity. Therefore, the composite membrane crosslinked by TGase had satisfactory anti-adhesive effects with high biocompatibility and low antigenicity, which could be used as a preventive barrier for peritoneal adhesion.

Preparation of Antibacterial Cellulose Paper Using Layer-by-Layer Assembly for Cooked Beef Preservation at Ambient Temperature

Positively-charged ε-poly(l-lysine) (ε-PL) and negatively-charged carboxymethyl cellulose (CMC) were alternately deposited on a cellulose paper surface by the layer-by-layer (LBL) assembly technique. The formation of ε-PL/CMC multilayers was confirmed by X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectra (FTIR), and zeta potential measurement. The morphologies of the multilayer-modified cellulose paper were observed by scanning electron microscopy (SEM). The ε-PL/CMC multilayers effectively improved not only the antibacterial activity of cellulose paper against both Escherichia coli and Staphylococcus aureus, but also the cellulose paper tensile strength property. Cellulose paper modified with a (ε-PL/CMC)4.5 multilayer exhibited the strongest antibacterial activity, selected for preserving cooked beef for nine days at ambient temperature, could extend the shelf-life of beef for about three days compared with common commercial PE films. The prepared antibacterial paper did not show any evidence of the cytotoxic effect since it could not increase the cytoplasmic lactate dehydrogenase release from L-929 fibroblast cells in contact with the antibacterial paper, suggesting the possibility of utilization in food packaging field.

In situ forming hydrogel composed of hyaluronate and polygalacturonic acid for prevention of peridural fibrosis

Hyaluronic acid-based hydrogels can reduce postoperative adhesion. However, the long-term application of hyaluronic acid is limited by tissue mediated enzymatic degradation. To overcome this limitation, we developed a polygalacturonic acid and hyaluronate composite hydrogel by Schiff's base crosslinking reaction. The polygalacturonic acid and hyaluronate composite hydrogels had short gelation time (less than 15 s) and degraded by less than 50 % in the presence of hyaluronidase for 7 days. Cell adhesion and migration assays showed polygalacturonic acid and hyaluronate composite hydrogels prevented fibroblasts from adhesion and infiltration into the hydrogels. Compared to hyaluronate hydrogels and commercial Medishield™ gels, polygalacturonic acid and hyaluronate composite hydrogel was not totally degraded in vivo after 4 weeks. In the rat laminectomy model, polygalacturonic acid and hyaluronate composite hydrogel also had better adhesion grade and smaller mean area of fibrous tissue formation over the saline control and hyaluronate hydrogel groups. Polygalacturonic acid and hyaluronate composite hydrogel is a system that can be easy to use due to its in situ cross-linkable property and potentially promising for adhesion prevention in spine surgeries.

Prevention of intra-abdominal adhesion by bi-layer electrospun membrane

The aim of this study was to compare the anti-adhesion efficacy of a bi-layer electrospun fibrous membrane consisting of hyaluronic acid-loaded poly(ε-caprolactone) (PCL) fibrous membrane as the inner layer and PCL fibrous membrane as the outer layer with a single-layer PCL electrospun fibrous membrane in a rat cecum abrasion model. The rat model utilized a cecal abrasion and abdominal wall insult surgical protocol. The bi-layer and PCL membranes were applied between the cecum and the abdominal wall, respectively. Control animals did not receive any treatment. After postoperative day 14, a visual semiquantitative grading scale was used to grade the extent of adhesion. Histological analysis was performed to reveal the features of adhesion tissues. Bi-layer membrane treated animals showed significantly lower adhesion scores than control animals (p < 0.05) and a lower adhesion score compared with the PCL membrane. Histological analysis of the bi-layer membrane treated rat rarely demonstrated tissue adhesion while that of the PCL membrane treated rat and control rat showed loose and dense adhesion tissues, respectively. Bi-layer membrane can efficiently prevent adhesion formation in abdominal cavity and showed a significantly decreased adhesion tissue formation compared with the control.

Synthesis of a disulfide cross-linked polygalacturonic acid hydrogel for biomedical applications

Polygalacturonic acid (PGA) hydrogel cross-linked via disulfide bonds was synthesized using a thiol oxidation reaction. PGA was grafted with cysteine to yield thiolated PGA (denoted PGAcys). Per gram, PGA-conjugated cysteine was 725 ± 77 μmol, and the degree of modification was 16.24 %. A PGAcys hydrogel film was fabricated under physiological conditions, with gel content 91.6 % and water content 43.3 %. The PGAcys hydrogel was used as a drug carrier for rosmarinic acid (RA) (denoted PGAcys/RA) and to prevent postsurgical adhesion. The in vitro dynamic release behavior of RA from the PGAcys hydrogel was analyzed. The profiles showed that 80 % of the total RA was released from the hydrogel within 15 min, followed by zero-order kinetic release. Animal implant studies showed that PGAcys and PGAcys/RA hydrogel films reduced adhesion incidence by over 90 %, significantly higher than did Hyaluronate/Carboxymethylcellulose (analogous Seprafilm™) (42 %). The PGAcys/RA hydrogel film also reduced the early inflammatory reaction.

Physical and biological effects of gellan gum on decreasing postoperative adhesion in a rat model

An antiadhesion membrane made from gellan gum was fabricated and characterized. A 12-µm-thick membrane of gellan gum was prepared and reacted with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide to obtain a cross-linked membrane (G/A70) with 87% gel content and a tensile strength of 46.5 MPa. In vivo, the G/A70 membrane had 90% less tissue adhesion. Inflammation-related and extracellular matrix protein gene expression in a rat model of abdominal surgery was found by real-time quantitative reverse transcription polymerase chain reaction analysis. On day 3, after surgery, the gene expression of ceruloplasmin and type V collagen in the G/A70-treated group was 1.9 and 0.3 times that of the control group, respectively. The G/A70 membrane elicited mild inflammation but suppressed type V collagen synthesis and reduced the occurrence of tissue adhesion. These findings provide insights into the properties of gellan gum antiadhesion membranes and help to overcome problems involving tissue adhesions in surgical procedures.

A novel injectable chitosan/polyglutamate polyelectrolyte complex hydrogel with hydroxyapatite for soft-tissue augmentation

This study demonstrated a chitosan (CS)/polyglutamate (PG) polyelectrolyte complex (PEC) hydrogel combined with spherical hydroxyapatite (HAp) particles as an injectable dermal filler for soft-tissue augmentation. The CS/PG PEC hydrogel with oppositely charged ionic cross-linking, a high gel content, and low degradation rate was introduced as a carrier to achieve high shape and volume stability. An MTT assay indicated that the CS/PG PEC had satisfactory cell biocompatibility. This PEC/HAp hydrogel showed good structural integrity in a PBS solution for up to 60 days. Clinical manageability was indexed by an injection force measurement through sterile 27-gauge needles using a texture analyzer. In an animal study, 0.2 mL of the PEC and PEC/hydroxyapatite (HAp) were implanted within the dorsal dermis of a swine ear. Injected tissue areas were biopsied 2 weeks, and 2 and 6 months after the injection. According to the histomorphometric results, the PEC and PEC/HAp groups showed percentages of retention of the maximum height of the cross-section of about 44% and 73% at 6 months. New collagen was observed in the central position indicating a possible collagenesis effect. These results suggest that this PEC/HAp system can be used as an alternative for soft-tissue augmentation.

Postoperative adhesion prevention using a statin-containing cellulose film in an experimental model

BACKGROUND

Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm(®)) in the prevention of postoperative intraperitoneal adhesions in rats.

METHODS

One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm(®) group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation.

RESULTS

All antiadhesive film groups (Seprafilm(®), placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm(®) in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm(®) group, but only one-quarter in the low-dose Statofilm group.

CONCLUSION

The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm(®) in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application.

Polygalacturonic acid hydrogel with short-chain hyaluronate cross-linker to prevent postoperative adhesion

The purpose of this study was to develop a poly(galacturonic acid) (PGA)-based hydrogel using a short-chain hyaluronate (sHA) cross-linker for medical applications. PGA was grafted with adipic acid dihydrazide (ADH) to yield PGA–ADH, an amine-containing PGA derivative. This PGA–ADH formed a water-insoluble hydrogel by reacting with 1,1′-carbonyldiimidazole (CDI)–grafted sHA (sHA–CDI) in aqueous solution. The sHA–cross-linked PGA hydrogel has a water content of about 94%–97% and compressive modulus of 10.7–26.9 kPa. The in vitro data indicated that the sHA–cross-linked PGA hydrogel is degradable and noncytotoxic, thus suitable for biomedical applications. Animal implant studies showed that the sHA–cross-linked PGA hydrogel membrane exhibited antiadhesion potency, significantly higher than that found in untreated rats and has great potential for future clinical applications.

Application of polycaprolactone as an anti-adhesion biomaterial film

Adhesions are unavoidable consequences of surgery and other trauma. How to prevent the adhesions remains a big issue in healthcare system. The objective of this study is to test the efficacy of polycaprolactone (PCL) films as physical barriers in reducing postoperative intra-abdominal adhesions in the rat cecum-abdominal wall model. PCL is quite cheap compared with the agents recently used in the market. The fabrication method is also very easy to perform. Scanning electron microscope (SEM) showed multiple pores over upper and bottom surfaces but too small to permit cells to migrate from one surface onto another surface. Those pores were proven to be not interconnected. The PCL film did not show any evidence of cytotoxic effects as it did not induce any significant increase in cytoplasmic lactate dehydrogenase release from the NIH3T3 cells that it came in contact with. In animal studies, the PCL films led to fewer adhesions than Seprafilm in rat adhesion model. PCL films were efficacious in reducing postoperative intra-abdominal adhesion formation in rat cecum-abdominal wall models.

In Situ Swelling Behavior of Chitosan-Polygalacturonic Acid/Hydroxyapatite Nanocomposites in Cell Culture Media

The molecular and mechanical characteristics of in situ degradation behavior of chitosan-polygalacturonic acid/hydroxyapatite (Chi-PgA-HAP) nanocomposite films is investigated using Fourier Transform Infrared spectroscopy (FTIR), Atomic Force Microscopy (AFM), and modulus mapping techniques for up to 48 days of soaking in cell culture media. The surface molecular structure of media-soaked samples changes over the course of 48 days of soaking, as indicated by significant changes in phosphate vibrations (1200–900 ) indicating apatite formation. Chitosan-Polygalacturonic acid polyelectrolyte complexes (PECs) govern structural integrity of Chi-PgA-HAP nanocomposites and FTIR spectra indicate that PECs remain intact until 48 days of soaking. In situ AFM experiments on media-soaked samples indicate that soaking results in a change in topography and swelling proceeds differently at the initial soaking periods of about 8 days than for longer soaking. In situ modulus mapping experiments are done on soaked samples by probing 1–3 nm of surface indicating elastic moduli of 4 GPa resulting from proteins adsorbed on Chi-PgA-HAP nanocomposites. The elastic modulus decreases by 2 GPa over a long exposure to cell culture media (48 days). Thus, as water enters the Chi-PgA-HAP sample, surface molecular interactions in Chi-PgA-HAP structure occur that result in swelling, causing small changes in nanoscale mechanical properties.

Agarose/collagen composite scaffold as an anti-adhesive sheet

The objective of this work was to find a new material or new technology to achieve satisfactory post-surgery anti-adhesion. An agarose/collagen composite sheet was developed to prevent mesenchymal cells and extracellular matrix from adhering on the lesion site, in which agarose formed uniaxial channels that hindered penetration and intercommunication of cells among pores in a 3D sheet. The tensile strength of the composite sheet in the designed ratio of agarose and collagen was over 17 MPa in dry and 2 MPa in wet, which was suitable and convenient to be sewed or operated on in other general surgery. In vitro and in vivo experimental results showed that fibroblasts, adult-derived adipose stem cells, could not penetrate into the sheet and formed a 3D tissue, and agarose did not degrade in three weeks. The demonstration that this sheet can prevent mesenchymal cells from penetrating in 3D and forming a tissue warrants the agarose-based composite for an anti-adhesive membrane.

Use of polylactic acid/polytrimethylene carbonate blends membrane to prevent postoperative adhesions

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.