Effects of a Temperature-Sensitive, Anti-Adhesive Agent on the Reduction of Adhesion in a Rabbit Laminectomy Model

Park, Jeong Woo; Bak, Koang Hum; Cho, Tae Koo; Chun, Hyoung Joon; Ryu, Je Il

doi:10.3340/jkns.2016.59.3.250

Cited by 5 publications

(6 citation statements)

References 55 publications

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“…Among various anti-adhesive agents, we have used a poloxamer 407/188-based thermosensitive gel (Mediclore®, CGbio Co., Ltd. Seongnam-si, Korea) [10]. The agent is a complex consisting of poloxamer 407/188, chitosan, and gelatin.…”

Section: Methodsmentioning

confidence: 99%

Effect of a poloxamer-based thermosensitive gel on rotator cuff repair in a rabbit model: a controlled laboratory study

et al. 2019

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Background A common complication after rotator cuff repair is postoperative stiffness, which can be reduced by a simple application of an anti-adhesive agent. However, anti-adhesive agents may affect rotator cuff healing by preventing fibrosis. This experimental animal study evaluated the effect of the application of a poloxamer-based thermosensitive anti-adhesive gel and its influence on the healing of an acute rotator cuff repair in a rabbit model. Methods Acute rotator cuff repair (supraspinatus tendon) was performed using a transosseous suturing method. One shoulder on a randomly selected side was treated with a local application of the anti-adhesive agent (applied side), and saline was applied to the contralateral side (control side). Biomechanical testing and histological analyses were performed at 4 and 8 weeks postoperatively. Eight rabbits were included for each testing and time point, for a total of 32 rabbits. Results The failure load at 4 weeks was lower in the experimental group (95.2 ± 19.6 N vs. 110.0 ± 20.5 N; P = 0.017). Conversely, at 8 weeks, the failure load was higher in the experimental group (148.3 ± 16.2 N) than in the control group (122.4 ± 16.9 N; P = 0.002). Histological analyses revealed no statistically significant differences in the tendon maturing scores at 4 and 8 weeks between the two groups (all P > 0.05). The thickness of the fibrosis between the rotator cuff tendon and deltoid was thinner in the experimental group at both time points (0.50 ± 0.25 vs. 1.27 ± 0.47; P = 0.002 at 4 weeks, and 0.37 ± 0.35 vs. 1.39 ± 0.50; P = 0.003 at 8 weeks). Conclusions Application of an anti-adhesive agent in this rotator cuff model confirmed the agent’s effectiveness at reducing fibrosis in the subacromial space. The healing of the tendon showed interesting results, as the experimental group had poorer biomechanical strength at 4 weeks but superior strength at 8 weeks.

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Section: Methodsmentioning

confidence: 99%

Effect of a poloxamer-based thermosensitive gel on rotator cuff repair in a rabbit model: a controlled laboratory study

et al. 2019

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“…39 Several in vivo studies have shown promising results of TAP hydrogel after spine surgery. 18,19 Poloxamer-based thermo-sensitive agent has shown superior efficacy over hyaluronate-based solution after laminectomy in a rabbit model. 18 However, the present clinical study showed that there was no enhancement of postoperative ROM after TKA in the TAP hydrogel group compared to the control group, consistent with results of a previous study that used conventional (ex-, without poloxamer) anti-adhesive agent periarticularly during TKA.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 Poloxamer-based thermo-sensitive agent has shown superior efficacy over hyaluronate-based solution after laminectomy in a rabbit model. 18 However, the present clinical study showed that there was no enhancement of postoperative ROM after TKA in the TAP hydrogel group compared to the control group, consistent with results of a previous study that used conventional (ex-, without poloxamer) anti-adhesive agent periarticularly during TKA. 8 Although TAP hydrogel is a new generation of hydrogel expected to have favorable results, it failed to improve ROM compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

“…17 Although some in vivo studies have shown the effectiveness of TAP hydrogel in spine surgery, studies about the clinical outcome after using TAP hydrogel in the knee joint especially in TKA have not been reported. 18,19 Therefore, the purpose of this study was to evaluate the efficacy and safety of TAP hydrogel on fascial adhesion and clinical outcomes including postoperative ROM, pain, and patient satisfaction after TKA.…”

Section: Introductionmentioning

confidence: 99%

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Temperature-sensitive anti-adhesive poloxamer hydrogel decreases fascial adhesion in total knee arthroplasty: A prospective randomized controlled study

et al. 2019

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A temperature sensitive anti-adhesive poloxamer (TAP) hydrogel has been developed to reduce post-operative adhesion. The purpose of this study was to evaluate the efficacy and safety of TAP hydrogel on fascial adhesion and clinical outcomes including range of motion, pain, and patient satisfaction after total knee arthroplasty. Sixty patients who underwent unilateral primary total knee arthroplasty for knee osteoarthritis were included and randomized to either TAP group or control group. After capsular closure, TAP hydrogel was applied on the fascial layer in 30 patients of the TAP hydrogel group, while normal saline was applied to 30 patients of the control group. The primary variable was range of motion at postoperative seven days, three months, and one year. As secondary outcomes, degree of skin fold, fascial thickness measured with ultra-sonography, postoperative pain visual analogue scale, total cumulative analgesics consumption, clinical scores, and degree of satisfaction were evaluated. There were no significant differences in range of motion after surgery between the two groups. However, the degree of suprapatellar skin folding in the TAP hydrogel group was less than that of the control group at six weeks after surgery (p = 0.041). There were no significant differences in postoperative fascial thickness, pain visual analogue scale, analgesics consumption, clinical scores, or degree of satisfaction. No surgical site complication was observed. The use of TAP hydrogel failed to enhance range of motion. However, application of TAP hydrogel on the fascial layer after capsular closure in total knee arthroplasty may decrease early postoperative fascial adhesion without any complications.

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“…Other experimental rabbit studies 4,6,19,21 about the degree of peridural adhesion after using Guardix-SG ® have lasted usually 4 to 6 weeks to allow time for dense fibrosis to form at the laminectomy site. In addition, previous studies have reported that significant bone regeneration can be seen about 9 weeks postoperatively in rabbit models 22 .…”

mentioning

confidence: 99%

Effects of a Temperature-sensitive, Anti-adhesive Agent on the Clinical Outcome of Carpal Tunnel Release Surgery

Min

Shin

2018

Arch Hand Microsurg

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Purpose:We investigated the anti-adhesive effects of a temperature-sensitive poloxamer/alginate mixture (Guardix-SG ® ; Hanmi Medicare Inc., Korea) through a prospective randomized controlled study for carpal tunnel release surgery. Methods: The 47 patients who received the infusion were classified as Group 1, and the 51 patients who did not were classified as Group 2. Basic demographic factors and preoperative clinical status were evaluated. At the postoperative 18 months, the degree of clinical recovery and adhesion around the median nerve for both groups were evaluated and compared using sonography. Results:The clinical outcomes, which were assessed using the six-item carpal tunnel symptoms scale, were not significantly different between the groups. However, sonography showed that adhesions around the median nerve were significantly less common in the infusion group. Conclusion: Although the anti-adhesive effects of the temperature-sensitive Guardix-SG® were apparent upon radiological investigation, its use was not associated with a significant difference in clinical outcome on the short-term period follow-up.

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Effects of a Temperature-Sensitive, Anti-Adhesive Agent on the Reduction of Adhesion in a Rabbit Laminectomy Model

Cited by 5 publications

References 55 publications

Effect of a poloxamer-based thermosensitive gel on rotator cuff repair in a rabbit model: a controlled laboratory study

Effect of a poloxamer-based thermosensitive gel on rotator cuff repair in a rabbit model: a controlled laboratory study

Temperature-sensitive anti-adhesive poloxamer hydrogel decreases fascial adhesion in total knee arthroplasty: A prospective randomized controlled study

Effects of a Temperature-sensitive, Anti-adhesive Agent on the Clinical Outcome of Carpal Tunnel Release Surgery

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