Biomaterials to Prevent Post-Operative Adhesion

Abstract

<jats:p>Surgery is performed to treat various diseases. During the process, the surgical site is healed through self-healing after surgery. Post-operative or tissue adhesion caused by unnecessary contact with the surgical site occurs during the normal healing process. In addition, it has been frequently found in patients who have undergone surgery, and severe adhesion can cause chronic pain and various complications. Therefore, anti-adhesion barriers have been developed using multiple biomaterials to prevent post-operative adhesion. Typically, anti-adhesion barriers are manufactured and sold in numerous forms, such as gels, solutions, and films, but there are no products that can completely prevent post-operative adhesion. These products are generally applied over the surgical site to physically block adhesion to other sites (organs). Many studies have recently been conducted to increase the anti-adhesion effects through various strategies. This article reviews recent research trends in anti-adhesion barriers.</jats:p>

Use of hypertonic glucose (10%) in the prevention of postoperative adhesions in rats

“…The solids can be absorbable (carboxymethylcellulose and oxidized regenerated cellulose) or nonabsorbable (expanded polytetrafluoroethylene) 2 . The liquid barriers are glycol polyethylene and solutions of icodextrin, hyaluronic acid, and plant polysaccharides 2 , 5 . These materials increase the cost of surgery and have unreliable effects in the prevention of adhesions 2 , 6 .…”

“…Methods for the prevention of adhesions are divided into surgical techniques, physical barriers, and pharmacological therapies 2 . No pharmacological therapy has been approved for clinical use, which justifies further research into these methods 2 , 5 . Among pharmacological therapies, fibrinolytic, anticoagulant, and anti-inflammatory agents (corticosteroids and nonsteroidal anti-inflammatory agents) have been used, which theoretically have the potential to be auxiliary agents against adhesion formation 5 , 6 .…”

“…No pharmacological therapy has been approved for clinical use, which justifies further research into these methods 2 , 5 . Among pharmacological therapies, fibrinolytic, anticoagulant, and anti-inflammatory agents (corticosteroids and nonsteroidal anti-inflammatory agents) have been used, which theoretically have the potential to be auxiliary agents against adhesion formation 5 , 6 . Corticosteroids alter the inflammatory response, thereby reducing vascular permeability and consequently decreasing the secretion of cytokines and chemotactic factors 6 .…”

Hyaluronic Acid Treatment Improves Healing of the Tenorrhaphy Site by Suppressing Adhesions through Extracellular Matrix Remodeling in a Rat Model

“…Among the numerous anti-adhesive agents that have been developed to date—such as alginate, chitosan, carboxymethyl cellulose, gelatin, silk fibroin, collagen, and hyaluronic acid (HA) as natural polymer-based barriers, as well as polyethylene glycol, polylactic acid, polyvinyl alcohol, and poly ε-caprolactone as synthetic polymer-based membrane-like barriers, which have been shown to prevent tendon adhesions—many have exhibited trade-offs between biological functions as anti-adhesive materials and mechanical stability [ 4 , 12 , 13 , 14 ]. In particular, HA has been extensively investigated because of its unique biological properties and biomechanical nature [ 15 ].…”

Antibacterial Layer-by-Layer Coatings for Medical Implants

“…A current challenge in the design of biomaterials for tissue engineering and implant fabrication is the need to inhibit bacterial adhesion/colonization while, at the same time, facilitating the desired interactions of the implant with cells and proteins [ 1 ]. Depending on the desired application one may aim to promote cell adhesion, migration, proliferation and differentiation, as in the case of tissue regeneration therapies [ 2 , 3 ], or prevent it, as in some surgical materials, or in biomaterials to prevent post-operative adhesions [ 4 , 5 ].…”