A functional PVA aerogel-based membrane obtaining sutureability through modified electrospinning technology and achieving promising anti-adhesion effect after cardiac surgery

Abstract

Pericardial barrier destruction, inflammatory cell infiltration, and fibrous tissue hyperplasia, trigger adhesions after cardiac surgery. There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction. Besides, a few studies have reported on the mechanism of preventing pericardial adhesion. Herein, a functional barrier membrane with sutureability was developed via a modified electrospinning method. It was composed of poly( l -lactide- co -caprolactone) (PLCL) nanofibers, poly(vinyl alcohol) (PVA) aerogel, and melatonin, named PPMT. The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section. Besides providing the porosity and hydrophilicity obtained from PVA, the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers. Furthermore, it inhibited the proliferation of fibroblasts by suppressing the activation of Fas and P53 , and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors, such as interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α). Finally, in vivo transplantation showed that it up-regulated the expression of matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase-1 (TIMP1), and down-regulated the expression of Vinculin and transforming growth factor β (TGF-β) in the myocardium, thereby reducing the formation of adhesions. Collectively, these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.

Prevention strategies of postoperative adhesion in soft tissues by applying biomaterials: Based on the mechanisms of occurrence and development of adhesions

“…Constructing double-layer or multilayer materials with excellent structural stability is the most used strategy. Among them, Janus porous hydrogel [ 175 , 288 ], hydrogel-electrospinning system [ 177 ], electrospinning-electrospinning system [ 334 ], electrospinning-cast film system [ 335 ], electrospinning-sheet system [ 336 , 337 ], sponge-hydrogel system [ 338 ], aerogel-electrospinning system [ 339 ] and layer-by-layer surface coating [ 340 ] show superiority and need wider application and research. In addition, the surface coating technology such as “hydrogel skin” [ 219 , 341 ] exhibited priority.…”

Establishments and Evaluations of Post‐Operative Adhesion Animal Models

“…[ 60 ] However, it is often stripped during the treatment of congenital heart disease in order to re‐establish normal blood circulation. [ 61 ] Cardiac adhesions after heart surgery are theoretically unavoidable, and if not treated appropriately, these adhesions can lead to cardiac insufficiency and, in severe cases, even to sudden death. In addition, cardiac adhesions can also lead to increased difficulty during reoperation and even cause serious damage to the lungs or large blood vessels.…”

“…grafted PP membranes in a pericardial defect repair, which were seen to form fibrous chains of varying degrees on the visceral layer. [ 61 ] Also, the production of inflammatory cells and collagen fibers can be seen in the pathological staining images of IUA [ 28 ] (Figure 9e), spinal adhesions [ 95 ] (Figure 9f), tendon adhesions [ 74 ] (Figure 9g), and intra‐articular adhesions [ 30 ] (Figure 9h).…”

Insight into Heart-Tailored Architectures of Hydrogel to Restore Cardiac Functions after Myocardial Infarction

“…77 A functional barrier membrane with a suture ability consisting of melatonin, PVA aerogel and poly(L-lactideco-caprolactone) (PLCL) nanofibers, named PPMT, was found to up-regulate expression of MMP-1 and TIMP-1, down-regulate expression of transforming growth factor β (TGF-β) and Vinculin, thus decreasing adhesion formation. 78 Inspired by strong wet adhesive properties of complexation by self-polymerized dopamine and dopamine-Fe 3+ , 45 gelatin and HA synthesized hydrogels by mixing gelatin-dopamine (GelDA) and dopamine-modified PPy (DA-PPy) under Fe 3+ triggering, which possessed an adhesive property. The combination treatment of MI was achieved by two steps: injecting oxidized sodium HA (HA-CHO)/hydrazided HA (HHA) hydrogel into the infarct region and painting the GelDA/DA-PPy hydrogel on the cardiac surface.…”

“…A self-healing nanoscaled delivery hydrogel composed of PEG and silicate nanodisks is able to coat the epicardial surface to protect the intrapericardial space postsurgery . A functional barrier membrane with a suture ability consisting of melatonin, PVA aerogel and poly­( l -lactide- co -caprolactone) (PLCL) nanofibers, named PPMT, was found to up-regulate expression of MMP-1 and TIMP-1, down-regulate expression of transforming growth factor β (TGF-β) and Vinculin, thus decreasing adhesion formation …”