Histological and Immunohistological Evaluation of the Tissue Response of a New Barrier Material Based on D,L-Polylactide, Trimethylene Carbonate and Caprolactone to Prevent Peritoneal Adhesion Formation

Abstract

Serosal membranes cover body cavities and guarantee frictionless gliding of inner organs. Serosal damage carries the risk of adhesion formation, which represents a relevant postoperative complication. Due to pathophysiological similarities between serous and dermal wound healing, the efficacy of SupraSeal ® in intraabdominal adhesion prevention was investigated at early time points. After standardized serosal damage, Wistar rats were examined macroscopically, histologically and immunohistochemically on days two, four and eight postoperatively. On day eight, all specimens of the control group presented distinctive adhesions consisting of fibrous tissue bands. In contrast, most specimens covered by SupraSeal ® were adhesion-free. Merely mild adhesion formation due to suture material used for fixation was detected. Histologically, SupraSeal ® revealed rapid clearance of fibrin and a marked lack of fibrosis. For the first time, the histomorphological effects of SupraSeal ® on adhesion formation over time are described and the relevance of the early stage of wound healing elucidated.Since peritoneal damage with mesothelial-free areas is crucial for the formation of peritoneal adhesions, various material-based approaches are already clinically available to cover and shield denuded

Poly(amino acid) based fibrous membranes with tuneable in vivo biodegradation

“…Although no standardized protocol for specifically evaluating foreign body inflammatory reactions exists, some indicators are widely accepted as criteria of grading the inflammatory response and used in other areas of medicine. For quantifying the immune response and inflammatory grade to the implanted samples, a scoring system based on the work of Planck et al was used as shown in Table 1 [36]. A small piece from the 7 th day PSIDAB was collected with a tweezer and investigated by a multiphoton microscope without any staining, and after freeze-drying by SEM to try and visualize leukocytes (macrophages, lymphocytes).…”

“…However, in neither case was this inflammation considered as a strong reaction. According to the scoring of Planck et al [36] this inflammatory response is considered mild or moderate in the case of the PSIDAB samples (Table 2). PASPCYS samples were easily found on the slides surrounded by a rim of inflammatory cells predominantly comprising neutrophil granulocytes (Fig 6C…”