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Sato K, Kotani T, Sakuma T, Iijima Y, Asada T, Akazawa T, Minami S, Ohtori S, Koda M, Yamazaki M. Prevalence of pleural injury in an extrapleural approach to adolescent idiopathic scoliosis and association of pleural injury with postoperative respiratory function. J Orthop Sci 2024; 29:71-77. [PMID: 36460556 DOI: 10.1016/j.jos.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/01/2022] [Accepted: 11/06/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND The prevalence of pleural injury during surgery for adolescent idiopathic scoliosis using an extrapleural approach and the association of pleural injury with postoperative pulmonary function remain unclear. We sought to determine the prevalence of pleural injury associated with an extrapleural approach to adolescent idiopathic scoliosis, and to determine any difference in respiratory function between patients with or without pleural injury. METHODS Data from consecutive patients with scoliosis of the thoracolumbar/lumbar spine who underwent anterior spinal fusion using an extrapleural approach were assessed in this retrospective study. We had diagnosed and treated pleural injury according to our algorithm. Pre- and postoperative values of pulmonary function tests and postoperative change rates were compared between patients with and without pleural injury. FVC, %FVC, FEV1.0, and FEV1.0% were evaluated from pulmonary function tests. RESULTS We included data from 51 patients with adolescent idiopathic scoliosis (45 female and 6 male) with a mean age of 17.2 ± 3.5 years in this retrospective study. The group with pleural injury comprised 31 patients and the group without 20. Therefore, the prevalence of pleural injury during an extrapleural approach was 61%. We found no significant differences in preoperative FVC, %FVC, FEV1.0, and FEV1.0% between the groups. We found no significant differences in FVC, %FVC, FEV1.0, and FEV1.0% between the groups at 3 months or 1 year postoperatively. Furthermore, we found no significant differences in the postoperative change ratio of FVC, %FVC, FEV1.0, and FEV1.0% between the groups. CONCLUSION The prevalence of pleural injury associated with an extrapleural approach to scoliosis was 61%. Pleural injury was not associated with a decrease in postoperative pulmonary function in patients with scoliosis treated using an extrapleural approach.
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Affiliation(s)
- Kosuke Sato
- Seirei Sakura Citizen Hospital, Department of Orthopedic Surgery, Sakura, Japan; University of Tsukuba, Faculty of Medicine, Department of Orthopaedic Surgery, Tsukuba, Japan.
| | - Toshiaki Kotani
- Seirei Sakura Citizen Hospital, Department of Orthopedic Surgery, Sakura, Japan
| | - Tsuyoshi Sakuma
- Seirei Sakura Citizen Hospital, Department of Orthopedic Surgery, Sakura, Japan
| | - Yasushi Iijima
- Seirei Sakura Citizen Hospital, Department of Orthopedic Surgery, Sakura, Japan
| | - Tomoyuki Asada
- University of Tsukuba, Faculty of Medicine, Department of Orthopaedic Surgery, Tsukuba, Japan
| | - Tsutomu Akazawa
- St. Marianna University, School of Medicine, Department of Orthopaedic Surgery, Kawasaki, Kanagawa, Japan
| | - Shohei Minami
- Seirei Sakura Citizen Hospital, Department of Orthopedic Surgery, Sakura, Japan
| | - Seiji Ohtori
- Chiba University, Graduate School of Medicine, Department of Orthopedics Surgery, Chiba, Japan
| | - Masao Koda
- University of Tsukuba, Faculty of Medicine, Department of Orthopaedic Surgery, Tsukuba, Japan
| | - Masashi Yamazaki
- University of Tsukuba, Faculty of Medicine, Department of Orthopaedic Surgery, Tsukuba, Japan
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Flutur IM, Păduraru DN, Bolocan A, Palcău AC, Ion D, Andronic O. Postsurgical Adhesions: Is There Any Prophylactic Strategy Really Working? J Clin Med 2023; 12:3931. [PMID: 37373626 DOI: 10.3390/jcm12123931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Postoperative adhesions are a frequent complication encountered after surgical procedures, mainly after intraperitoneal interventions. To this day, the pathophysiological mechanism behind the process of adhesions formation is not completely known. There are many strategies proposed as prophylaxis methods, involving surgical techniques, drugs or materials that prevent adhesions and even state of the art technologies such as nanoparticles or gene therapy. The aim of our review is to present these innovative approaches and techniques for postoperative adhesions prevention. After a thorough scientific database query, we selected 84 articles published in the past 15 years that were relevant to our topic. Despite all the recent groundbreaking discoveries, we are at an early stage of understanding the complexity of the adhesion formation mechanism. Further investigations should be made in order to create an ideal product for safe clinical use for prevention.
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Affiliation(s)
- Irina-Maria Flutur
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dan Nicolae Păduraru
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- IIIrd Clinic of General and Emergency Surgery, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania
| | - Alexandra Bolocan
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- IIIrd Clinic of General and Emergency Surgery, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania
| | - Alexandru Cosmin Palcău
- IIIrd Clinic of General and Emergency Surgery, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania
| | - Daniel Ion
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- IIIrd Clinic of General and Emergency Surgery, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania
| | - Octavian Andronic
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- IIIrd Clinic of General and Emergency Surgery, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania
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Fan ML, Tong HQ, Sun T, Zhang HW, Han J, Cheng SY, Lu SF, Han X, Zhang Q, Sun WX, Chen JD, Chen XH. Animal model of coronary microembolization under transthoracic echocardiographic guidance in rats. Biochem Biophys Res Commun 2021; 568:174-179. [PMID: 34246051 DOI: 10.1016/j.bbrc.2021.05.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/14/2021] [Indexed: 11/20/2022]
Abstract
The aim of the study was to develop a model of coronary microembolization (CME) in rats at a lower cost. We developed a novel rat model without thoracotomy and ventilation under the guidance of echocardiography. Rats were sacrificed at 3 h, 24 h and 1 month postoperatively in both the Echo-CME and Open-chest CME groups for the comparison of the modeling accuracy, mortality, cardiopulmonary circulation, pleural adhesion and ventilation-induced lung injury (VILI). Results showed that the coronary microthrombus formed at 3 h and reached its peak at 24 h postoperatively, which included platelet aggregation and fibrin web. The Echo-group increases success rates, decreased mortality, postoperative complications including pleural adhesion, cardiopulmonary dysfunction and VILI postoperatively than the Open-chest group at 1month postoperatively. The ejection fraction of the CME group decreased to 50% and obvious cardiac fibrosis formed at 3 months postoperatively. Our unique surgical method provided a platform to study molecular mechanisms and potential new pathways for CME treatment.
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Affiliation(s)
- Man-Lu Fan
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China; Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Hua-Qin Tong
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China; Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Tong Sun
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China; Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Hao-Wen Zhang
- School of Health Preservation and Rehabilitation, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jie Han
- Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Song-Yi Cheng
- Department of Cardiology, Nanjing Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210001, China
| | - Sheng-Feng Lu
- Acupuncture and Tuina College, Nanjing University of Chinese Medicine, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Xuan Han
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Qian Zhang
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Wei-Xin Sun
- First College of Clinical Medicine, Biological Technology Center for Innovation in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China; Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China
| | - Jian-Dong Chen
- Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China.
| | - Xiao-Hu Chen
- Department of Cardiology, Jiangsu Provincial Hospital of Chinese Medicine, Nanjing, 210029, China.
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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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Kawai N, Suzuki S, Ouji Y, Takeda M, Sakagami M, Tojo T, Sawabata N, Yoshikawa M, Ikada Y, Taniguchi S. Effect of covering with cross-linked gelatin glue on tissue regeneration in a rat lung injury model. Interact Cardiovasc Thorac Surg 2019; 29:1-7. [PMID: 30793739 DOI: 10.1093/icvts/ivy297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/05/2018] [Accepted: 09/22/2018] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- Norikazu Kawai
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan.,Department of Pathogen, Infection and Immunity, Nara Medical University, Nara, Japan
| | - Shuko Suzuki
- Department of Medical Engineering, Nara Medical University, Nara, Japan.,Queensland Eye Institute, South Brisbane, Queensland, Australia
| | - Yukiteru Ouji
- Department of Pathogen, Infection and Immunity, Nara Medical University, Nara, Japan
| | | | - Masaharu Sakagami
- Department of Pathogen, Infection and Immunity, Nara Medical University, Nara, Japan
| | - Takashi Tojo
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
| | - Noriyoshi Sawabata
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
| | - Masahide Yoshikawa
- Department of Pathogen, Infection and Immunity, Nara Medical University, Nara, Japan
| | - Yoshito Ikada
- Department of Medical Engineering, Nara Medical University, Nara, Japan.,Kyoto University, Kyoto, Japan
| | - Shigeki Taniguchi
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan
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Uemura A, Tanaka R. The importance of antiadhesion treatment for the successful video-assisted thoracic surgery. J Thorac Dis 2019; 11:59-61. [PMID: 30863572 DOI: 10.21037/jtd.2019.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Akiko Uemura
- Faculty of Veterinary Medicine, Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan.,Faculty of Life & Environmental Sciences, Department of Animal Sciences, Teikyo University of Science, Tokyo, Japan
| | - Ryou Tanaka
- Faculty of Veterinary Medicine, Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Ishihara S, Ito K, Okada S, Shimomura M, Shimada J, Yamaguchi T, Inoue M. Suppressive Effects of Aspirin for Postthoracotomy Pleural Adhesion in Rats. Int J Med Sci 2019; 16:593-601. [PMID: 31171911 PMCID: PMC6535663 DOI: 10.7150/ijms.32632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/23/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Postoperative adhesion is one of major concerns at re-thoracotomy. Aspirin has both the anti-platelet and anti-inflammatory effects, and decreases several cytokines production. OBJECTIVE We investigated that aspirin could reduce postoperative adhesion formation in a rat model. METHODS We cauterised the lung visceral pleural to make postoperative adhesion in rats. The animals were allocated to a control group and an aspirin administration group (100 mg/kg/day for 14 days). We performed re-thoracotomy and evaluated the adhesion lengths on day 14. We also investigated the cytokine expression in the adhesion region and the peripheral tissue with platelet-derived growth factor (PDGF), platelet-derived growth factor receptor (PDGFR), alpha smooth muscle actin (α-SMA), transforming growth factor beta 1 (TGF-β1), and vascular endothelial growth factor-A (VEGF-A), sequentially. RESULTS The adhesion lengths were significantly shorter in the aspirin group than that in the control group (8.7±2.0 mm vs 11.2±1.1 mm, p=0.024). The expressions of PDGF and PDGFR were lower in the aspirin group than that in the control group on day 3. The expression of α-SMA on fibroblasts decreased in the aspirin group on day 3. There was no significant difference in the expressions of TGF-β1 and VEGF-A with administration of aspirin. CONCLUSIONS Aspirin could reduce postoperative pleural adhesion by inhibiting the expression of PDGF.
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Affiliation(s)
- Shunta Ishihara
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kazuhiro Ito
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Satoru Okada
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Masanori Shimomura
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Junichi Shimada
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tadanori Yamaguchi
- Department of Cytopathology, Ayabe City Hospital, 20-1 Aono-cho Ootuka, Ayabe 623-0011, Japan
| | - Masayoshi Inoue
- Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
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Uemura A, Takiguchi M, Funakoshi K, Noishiki Y, Ogawa S, Tanaka R. Assessment of the subcutaneous degradation process of insoluble hyaluronic acid in rats. Biochem Biophys Res Commun 2018; 505:511-515. [PMID: 30269818 DOI: 10.1016/j.bbrc.2018.09.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 09/22/2018] [Indexed: 10/28/2022]
Abstract
Insoluble hyaluronic acid (IHA) may prevent adhesions by forming a physical barrier during the period when postoperative adhesions form. This study was performed to verify the changes that a solid IHA membrane undergoes as it is degraded in vivo, and to ascertain the swelling rate of IHA required for it to function as a physical barrier during the postoperative adhesion formation period. Nine female WI rats weighing 300-400 g were used. Discs 8 mm in diameter were cut out of dry IHA membranes made of IHA with a swelling rate (wet weight/dry weight) of either 2.47 (high-swelling IHA) or 1.94 (low-swelling IHA). They were placed in saline to swell and then washed with saline before subcutaneous implantation in four pockets in each rat. The high-swelling IHA started to degrade more rapidly than the low-swelling IHA. There was no evidence of degradation of the low-swelling IHA until day 7, but once it had started, the speed of degradation tended to be similar to that of the high-swelling IHA. The present results showed that, when IHA is implanted subcutaneously in rats, it is degraded over time in a phased process. The swelling rate required for the use of IHA as a postoperative adhesion barrier was also suggested.
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Affiliation(s)
- Akiko Uemura
- Faculty of Life & Environmental Sciences, Department of Animal Sciences, Teikyo University of Science, 2-2-1 Senjusakuragi, Adachi-ku, Tokyo, 120-0045, Japan; Faculty of Veterinary Medicine, Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, 3-5-8 Saiwaicho, Fuchu, Tokyo, 183-8509, Japan.
| | - Masahito Takiguchi
- Neuroanatomy, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kengo Funakoshi
- Neuroanatomy, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yasuharu Noishiki
- Neuroanatomy, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Shingo Ogawa
- R&D Department of Medical Field Product and Cosmetics Material, Fundamental Research Division, Dainichiseika Color & Chemicals Mfg. Co., Ltd, 1-9-4, Horinouchi, Adachi-ku, Tokyo, Japan
| | - Ryou Tanaka
- Faculty of Veterinary Medicine, Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, 3-5-8 Saiwaicho, Fuchu, Tokyo, 183-8509, Japan
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Newly Developed Polyglycolic Acid Reinforcement Unified with Sodium Alginate to Prevent Adhesion. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4515949. [PMID: 29850517 PMCID: PMC5903349 DOI: 10.1155/2018/4515949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/26/2017] [Accepted: 11/07/2017] [Indexed: 11/24/2022]
Abstract
Polyglycolic acid (PGA) mesh fabric is widely used for reinforcing injured tissues during surgeries. However, PGA induces chronic inflammation and adhesion. The purpose of this study is to develop PGA reinforcement “without PGA-induced adhesion.” We developed a reinforcement fabric unified with PGA mesh and alginate foam. The antiadhesive effects of sodium alginate foam and calcium alginate foam were evaluated in rats. Sodium alginate foam unified with PGA mesh fabric exhibited strong effects that limit the extent and severity of adhesion, whereas calcium alginate foam unified with PGA mesh was less effective in preventing adhesion. In the sodium alginate group, fibroblasts and collagen fibers around implanted sites were sparse and the material degraded rapidly by macrophage ingestion. Fibroblasts and collagen fibers play a major role in adhesion formation and their excessive proliferation results in postoperative adhesion. Thus, inhibiting their increase is the key in preventing PGA-induced adhesion. The reinforcement that is composed of PGA mesh unified with sodium alginate foam strongly inhibited PGA-induced adhesion and showed excellent handling during surgery and could be easily applied with a one-step procedure.
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Zhang Y, Fang S, Dai J, Zhu L, Fan H, Tang W, Fan Y, Dai H, Zhang P, Wang Y, Xing X, Yang C. Experimental study of ASCs combined with POC-PLA patch for the reconstruction of full-thickness chest wall defects. PLoS One 2017; 12:e0182971. [PMID: 28800620 PMCID: PMC5553644 DOI: 10.1371/journal.pone.0182971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/27/2017] [Indexed: 12/30/2022] Open
Abstract
To explore the repairing effect of combination of adipose stem cells (ASCs) and composite scaffolds on CWR, the electrospun Poly 1, 8-octanediol-co-citric acid (POC)-poly-L-lactide acid (PLA) composite scaffolds were prepared, followed by in vitro and in vivo biocompatibility evaluation of the scaffolds. Afterwards, ASCs were seeded on POC-PLA to construct the POC-PLA-ASCs scaffolds, and the POC-PLA, POC-PLA-ASCs, and traditional materials expanded polytetrafluoroethylene (ePTFE) were adopt for CWR in New Zealand white (NZW) rabbit models. As results, the POC-PLA-ASCs patches possessed good biocompatibility as the high proliferation ability of cells surrounding the patches. Rabbits in POC-PLA-ASCs groups showed better pulmonary function, less pleural adhesion, higher degradation rate and more neovascularization when compared with that in other two groups. The results of western blot indicated that POC-PLA-ASCs patches accelerated the expression of VEGF and Collagen I in rabbit models. From the above, our present study demonstrated that POC-PLA material was applied for CWR successfully, and ASCs seeded on the sheets could improve the pleural adhesions and promote the reparation of chest wall defects.
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Affiliation(s)
- Yuanzheng Zhang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Shuo Fang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Jiezhi Dai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, PR China
| | - Lei Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai, PR China
| | - Hao Fan
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Weiya Tang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Yongjie Fan
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Haiying Dai
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Peipei Zhang
- Department of Plastic Surgery, the 455th hospital of Chinese People's Liberation Army, Shanghai, PR China
| | - Ying Wang
- Department of Plastic Surgery, the 455th hospital of Chinese People's Liberation Army, Shanghai, PR China
| | - Xin Xing
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
- * E-mail: (XX); (CY)
| | - Chao Yang
- Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China
- * E-mail: (XX); (CY)
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11
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Uemura A, Nakata M, Goya S, Fukayama T, Tanaka R. Effective new membrane for preventing postthoracotomy pleural adhesion by surface water induction technology. PLoS One 2017; 12:e0179815. [PMID: 28654705 PMCID: PMC5487045 DOI: 10.1371/journal.pone.0179815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 06/05/2017] [Indexed: 11/18/2022] Open
Abstract
Background After thoracic surgery, adhesions between the pleura can cause substantial complications. This study investigated the effectiveness of a novel membrane utilizing surface water induction technology to prevent adhesions. Methods Eight beagles were divided into an experimental group (five males) and a control group (three females). The experimental group underwent thoracotomy on both the left and right sides of the chest. Both sides received the membrane, and the membrane on one side was glued to the pleura using tissue adhesive. The control group underwent thoracotomy only on the left side. Two weeks postoperatively, all dogs were sacrificed and adhesions were evaluated macroscopically and microscopically. Results Severe adhesion was seen between the parietal and visceral pleura in all control dogs, whereas the experimental group showed minor adhesion in only one dog on one side. Conclusions Our novel anti-adhesive membrane appeared highly effective in preventing postthoracotomy pleural adhesions.
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Affiliation(s)
- Akiko Uemura
- Tokyo University of Agriculture and Technology Animal Medical Center, Fuchu-shi, Tokyo, Japan
- * E-mail: (AU); (RT)
| | - Mary Nakata
- Tokyo University of Agriculture and Technology Animal Medical Center, Fuchu-shi, Tokyo, Japan
| | - Seijirow Goya
- Tokyo University of Agriculture and Technology Animal Medical Center, Fuchu-shi, Tokyo, Japan
| | | | - Ryou Tanaka
- Tokyo University of Agriculture and Technology Animal Medical Center, Fuchu-shi, Tokyo, Japan
- * E-mail: (AU); (RT)
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13
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Hamaji M, Burt BM, Date H, Nakamura T. Basic experiments of bioabsorbable materials in prevention of postoperative intrapleural adhesions following thoracotomy. Gen Thorac Cardiovasc Surg 2015; 64:82-6. [DOI: 10.1007/s11748-015-0612-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Indexed: 11/30/2022]
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Yan S, Yue YZ, Zeng L, Yue J, Li WL, Mao CQ, Yang L. Effect of intra-abdominal administration of ligustrazine nanoparticles nano spray on postoperative peritoneal adhesion in rat model. J Obstet Gynaecol Res 2015; 41:1942-50. [PMID: 26419644 DOI: 10.1111/jog.12807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 06/14/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Shuai Yan
- Suzhou Hospital of Traditional Chinese Medicine; Suzhou China
| | - Yin-zi Yue
- Suzhou Hospital of Traditional Chinese Medicine; Suzhou China
| | - Li Zeng
- Library of Nanjing University of Chinese Medicine; Nanjing China
| | - Jin Yue
- Yancheng Hospital of Traditional Chinese Medicine; Yancheng China
| | - Wen-lin Li
- Library of Nanjing University of Chinese Medicine; Nanjing China
| | - Chun-qin Mao
- School of Pharmacy; Nanjing University of Chinese Medicine; Nanjing China
| | - Lan Yang
- Library of Nanjing University of Chinese Medicine; Nanjing China
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Prevention of Polyglycolic Acid-Induced Peritoneal Adhesions Using Alginate in a Rat Model. BIOMED RESEARCH INTERNATIONAL 2015; 2015:403413. [PMID: 26078949 PMCID: PMC4454711 DOI: 10.1155/2015/403413] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/17/2014] [Indexed: 11/17/2022]
Abstract
Postoperative intra-abdominal or intrathoracic adhesions sometimes cause significant morbidity. We have designed three types of alginate-based treatments using strongly cross-linked (SL), weakly cross-linked (WL), and non-cross-linked (NL) alginate with calcium gluconate. In rat experiments, we compared the antiadhesive effects of the three types of alginate-based treatments, fibrin glue treatment (a standard treatment), and no treatment against adhesions caused by polyglycolic acid (PGA) mesh (PGA-induced adhesions). The antiadhesive materials were set on the PGA sheet fixed on the parietal peritoneum of the abdomen. Fifty-six days later, the adhesions were evaluated macroscopically by the adhesion scores and microscopically by hematoxylin-eosin staining and immunostaining. We also tested the fibroblast growth on the surface of the antiadhesive materials in vitro. The antiadhesive effects of WL and NL were superior to the no treatment and fibrin glue treatment. A microscopic evaluation confirmed that the PGA sheet was covered by a peritoneal layer constructed of well-differentiated mesothelial cells, and the inflammation was most improved in the NL and WL. The fibroblast growth was inhibited most on the surfaces of the NL and WL. These results suggest that either the WL or NL treatments are suitable for preventing PGA-induced adhesions compared to SL or the conventional treatment.
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Yoshizawa K, Taguchi T. Bonding behavior of hydrophobically modified gelatin films on the intestinal surface. J BIOACT COMPAT POL 2014. [DOI: 10.1177/0883911514553731] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The bonding behavior was determined for hydrophobically modified alkaline-treated gelatin on wet porcine intestinal surfaces. The modified gelatin films were obtained by reacting the amino groups of alkaline-treated gelatin with fatty acid chlorides of different alkyl chain lengths, namely, hexanoyl (Hx: C6) chloride, decanoyl (Dec: C10) chloride, and stearoyl (Ste: C18) chloride. Three kinds of the films were prepared, 32HxAlGltn, 24DecAlGltn, and 26SteAlGltn that had substitution ratios of hydrophobic groups to the amino groups of 32HxAlGltn, 24DecAlGltn, and 26SteAlGltn of 32%, 24%, and 26%, respectively. The 32HxAlGltn film had the strongest bonding to porcine intestinal surfaces. A thick 32HxAlGltn film remained on the intestinal surface even after the bonded film was scraped off for the measurement of bonding strength. In addition, the burst strength increased with an increase in the substitution ratio of the Hx group. Thus, the HxAlGltn film with the higher Hx modification ratio has a potential as a sealant material to prevent agglutination of intestinal surfaces.
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Affiliation(s)
- Keiko Yoshizawa
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tetsushi Taguchi
- Graduate School of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Japan
- Biomaterials Unit, Nano-Life Field, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science, Tsukuba, Japan
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Bodega F, Sironi C, Porta C, Zocchi L, Agostoni E. Pleural mesothelium lubrication after phospholipase treatment. Respir Physiol Neurobiol 2014; 194:49-53. [PMID: 24486606 DOI: 10.1016/j.resp.2014.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 11/28/2022]
Abstract
Coefficient of kinetic friction (μ) of rabbit pleural mesothelium increased after short treatment of specimens with phospholipase C. This increase was removed by addition of a solution with hyaluronan or sialomucin, as previously shown in post-blotting Ringer or after short pronase treatment. After phospholipase μ decreased with increase in sliding velocity, but at highest velocity it was still greater than control; this difference was removed by addition of hyaluronan or sialomucin, as in post-blotting Ringer or after short pronase treatment. Hyaluronan placed on specimen before phospholipase treatment reduced increase in μ by protecting phospholipids from enzyme, as shown by others for alveolar and synovial phospholipids. Samples of parietal pleura stained with silver nitrate showed that mesothelial cells were not disrupted by short phospholipase treatment. Instead, they were disrupted if this treatment was preceded by a short pronase treatment; but even after this disruption addition of hyaluronan or sialomucin brought μ back to control.
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Affiliation(s)
- Francesca Bodega
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Chiara Sironi
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Cristina Porta
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Luciano Zocchi
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy
| | - Emilio Agostoni
- Dipartimento di Fisiopatologia e dei Trapianti, Sezione di Fisiologia Umana, Università degli Studi di Milano, Milan, Italy.
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Prevention of post-surgical peritoneal adhesion in rats using curdlan and gellan gum hydrogels. Macromol Res 2013. [DOI: 10.1007/s13233-012-0184-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brochhausen C, Schmitt VH, Planck CNE, Rajab TK, Hollemann D, Tapprich C, Krämer B, Wallwiener C, Hierlemann H, Zehbe R, Planck H, Kirkpatrick CJ. Current strategies and future perspectives for intraperitoneal adhesion prevention. J Gastrointest Surg 2012; 16:1256-74. [PMID: 22297658 DOI: 10.1007/s11605-011-1819-9] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 12/28/2011] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The formation of peritoneal adhesions still is a relevant clinical problem after abdominal surgery. Until today, the most important clinical strategies for adhesion prevention are accurate surgical technique and the physical separation of traumatized serosal areas. Despite a variety of barriers which are available in clinical use, the optimal material has not yet been found. DISCUSSION Mesothelial cells play a crucial physiological role in friction less gliding of the serosa and the maintenance of anantiadhesive surface. The formation of postoperative adhesions results from a cascade of events and is regulated by various cellular and humoral factors. Therefore, optimization or functionalization of barrier materials by developments interacting with this cascade on a structural or pharmacological level could give an innovative input for future strategies in peritoneal adhesion prevention. For this purpose, the proper understanding of the formal pathogenesis of adhesion formation is essential. Based on the physiology of the serosa and the pathophysiology of adhesion formation, the available barriers in current clinical practice as well as new innovations are discussed in the present review.
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Affiliation(s)
- Christoph Brochhausen
- REPAIR-lab, Institute of Pathology, University Medical Centre, Johannes Gutenberg-University, Langenbeckstraße 1,55101 Mainz, Germany.
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