Electrospun Water-Borne Polyurethane Nanofibrous Membrane as a Barrier for Preventing Postoperative Peritendinous Adhesion

Abstract

Peritendinous adhesion is a major complication after tendon injury and the subsequent repairs or reconstructions. The degree of adhesion can be reduced by the interposition of a membranous barrier between the traumatized tendon and the surrounding tissue. In the present study, electrospun water-borne polyurethane (WPU) nanofibrous membranes (NFMs) were created for use after the reparation or reconstruction of tendons to reduce adhesion. In the electrospinning process, water was employed as the solvent for WPU, and this solvent was ecofriendly and nontoxic. The nanofibrous architecture and pore size of the WPU NFMs were analyzed. Their microporosity (0.78–1.05 µm) blocked the penetration of fibroblasts, which could result in adhesion and scarring around the tendon during healing. The release of WPU mimicked the lubrication effect of the synovial fluid produced by the synovium around the tendon. In vitro cell studies revealed that the WPU NFMs effectively reduced the number of fibroblasts that became attached and that there was no significant cytotoxicity. In vivo studies with the rabbit flexor tendon repair model revealed that WPU NFMs reduced the degree of peritendinous adhesion, as determined using a gross examination; a histological cross section evaluation; and measurements of the range of motion of interphalangeal joints (97.1 ± 14.7 and 79.0 ± 12.4 degrees in proximal and distal interphalangeal joints respectively), of the length of tendon excursion (11.6 ± 1.9 cm), and of the biomechanical properties.

Gelatin/Polycaprolactone Electrospun Nanofibrous Membranes: The Effect of Composition and Physicochemical Properties on Postoperative Cardiac Adhesion

“…Electrospinning has become a widely applied method to fabricate nanofibers due to its cost-effectiveness, simplicity, and suitability for mass production ( Xue et al, 2019 ; Keshvardoostchokami et al, 2020 ; Xu et al, 2021 ). Owing to its dense fibrous structure, tiny pore size, controllable mechanical properties, and adjustable degradation rate, the electrospun nanofibrous membrane has shown great potential in preventing postoperative adhesions as a physical barrier ( Chen et al, 2019 ; Alimohammadi et al, 2020 ; Mao et al, 2021 ). In our pilot study, we have discovered the elelctrospun GT/PCL (mass ratio 50:50) nanofibrous membrane might become a promising barrier to prevent postoperative cardiac adhesion ( Feng et al, 2019 ).…”

Ibuprofen-Loaded Hyaluronic Acid Nanofibrous Membranes for Prevention of Postoperative Tendon Adhesion through Reduction of Inflammation

“…This drastic reduction in the number of cells that penetrated an NFM in vitro also suggested its efficacy to prevent tendon adhesion in vivo due to the extrinsic fibroblastic cells. Indeed, the dense fiber morphology and the macroporous structure of the NFM shown in Figure 1 facilitates its use as a physical barrier to prevent postoperative adhesion [40]. That the number of penetrated cells of HAI40FB was significantly higher than HAI20FB may be due to the difference in pore sizes of the membrane [41].…”

Extracellular Vesicles of Adipose-Derived Stem Cells Promote the Healing of Traumatized Achilles Tendons

“…Thus, controlling inflammation and regulating cell growth, alignment, and components is important in the tendon regeneration field. Previous studies have shown the effectiveness and practical use of water-borne polyurethane nanofibrous membranous materials and other materials as barriers to reduce the degree of peritendinous adhesion in a rabbit model under safety [43,44]. On the other aspect of restoring the components and mechanical properties of injured tendons, there are still limited studies that report approaches that promote tissue regeneration, making tendon tissue regeneration a challenge in current therapeutic settings.…”

“…Mechanical strength is an indicator of tendon healing and functional outcomes [43,44,60,61]. A recent study showed improved biomechanical properties in a repaired rotator cuff model with treatment with exosome-embedded fibrin sealant [62].…”