An anti-inflammatory chondroitin sulfate-poly(lactic-co-glycolic acid) composite electrospinning membrane for postoperative abdominal adhesion prevention

Effects of Novel Cross-Linked Chondroitin Sulfate (SI-449) as a Postoperative Anti-Adhesion Barrier

INTRODUCTION

Postoperative adhesion often develops as a natural physiological response following abdominal and pelvic surgeries. Although existing resorbable adhesion barriers have reduced the incidence of postoperative adhesion formation, their clinical efficacy requires improvement. In this study, we generated a novel cross-linked, powder-formed chondroitin sulfate (SI-449) as an effective postoperative anti-adhesion barrier. We evaluated its anti-adhesion effect in animal models of abdominal and pelvic surgeries and elucidated its mechanism of action.

METHODS

Rats in the cecum-abraded adhesion and uterine horn adhesion models were treated with SI-449 and Seprafilm, and adhesion frequency and scores were evaluated. The mechanisms underlying this anti-adhesion effect were examined histopathologically using a cecum-abraded adhesion model.

RESULTS

In the cecum-abraded adhesion model, SI-449 reduced the adhesion frequency and total adhesion score to 30% and 1.6, respectively, compared with 100% and 8.1 in the control group and 50% and 2.5 in the Seprafilm group. We observed an SI-449-like substance between the cecum and abdominal wall and no fibrin net structure connecting the invasive tissues after surgery, as observed in the control group. In the rat uterine horn adhesion model, SI-449 reduced the adhesion frequency to 40%, compared with 100% in the control.

CONCLUSIONS

SI-449 exhibits anti-adhesion activity in animal models of postoperative adhesion. The mechanism of action of SI-449 during wound healing suggests mechanical obstruction of fibrin net structure formation, which is a key step in the development of adhesions at surgical sites. SI-449 is a promising candidate for preventing postoperative adhesions in clinical practice.

Biosafe Polydopamine-Decorated MnO2 Nanoparticles with Hemostasis and Antioxidative Properties for Postoperative Adhesion Prevention

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.