PLGA/PLCA casting and PLGA/PDPA electrospinning bilayer film for prevention of postoperative adhesion

Abstract

Postoperative adhesion is a common complication and preventing adhesions during or immediately after operation is particularly important. The application of solid barrier materials represents the most successful clinical strategy to prevent postoperative adhesion. However, a simple physical barrier effect might be insufficient in preventing adhesion satisfactorily. Multilayered structures can be designed with an outer layer as the barrier and an inner layer to respond to relative drug release. In this article, bilayer film composed of a PLGA/PLCA casting layer as barrier and PLGA/PDPA electrospinning layer to respond to the release of anti-fibrosis drug L-Phe was designed and synthesized. The adhesion prevention effect of the above PLGA/PLCA/PDPA bilayer film was examined and compared with single PLGA/PLCA casting film and single PLGA/PDPA electrospinning film by applying rabbit sidewall defect-cecum abrasion model. As demonstrated by histological observation and immunohistochemical analysis, the bilayer film was the most effective of the three films in postoperative adhesion prevention in terms of both physical barrier effect and anti-fibrosis effect of the PDPA macromolecular prodrug. Besides anti-fibrosis effect, PDPA could also suppress excess proliferation of vascular endothelial cells and microvessel caused by long-term stimulation of implantation materials to the surrounding tissues.

Biomaterials to Prevent Post-Operative Adhesion

“…PLGA is a biodegradable, aliphatic polyester-based synthetic polymer with good biodegradability and biocompatibility [ 213 ]. Niu et al prepared a PLGA/poly(lactide-co-caprolactone) (PLCA)/poly(L-phenylalanine-co-p-dioxanone (PDPA) film using an electrospinning and casting method and evaluated the performance of the bilayer film through an abdominal rabbit model [ 38 ]. Polypropylene (PP) is a thermoplastic polymer and is widely used in various research fields.…”

“…Their disadvantages are thus related to the biomaterials used [ 70 ]. Several studies have applied various biomaterials and technologies to establish anti-adhesion barriers [ 26 , 27 , 37 , 38 , 71 , 72 ]. These anti-adhesion biomaterials have excellent biocompatibility and biodegradability [ 73 , 74 ] and can be classified as either natural or synthetic polymers.…”

“…As a monomer, lactic acid has D and L optical isomers, and the properties of PLA can be varied by changing the ratio between the D form and L form [ 111 ]. PLA has a high melting point and excellent strength, but poor processability, poor flexibility, and high cost [ 38 ]. A method for producing lactic acid by fermenting corn was recently developed and has attracted attention due to its reduced manufacturing cost.…”

Advancement of Biomaterial‐Based Postoperative Adhesion Barriers

“…developed a bilayer film of poly( l ‐phenylalanine‐ co ‐ p ‐dioxanone (PDPA)/PLGA/poly(lactide‐ co ‐caprolactone) (PLCA) through electrospinning and casting method, the antiadhesion efficacy of which was evaluated in the rabbit side‐wall defect‐cecum abrasion model. [ 210 ] PLA has a high melting point, high mechanical strength, and good strength, but poor flexibility, poor processability, and costly. [ 210 ] PLA produces by lactic acid obtained from corn fermentation; this method was recently developed and widely accepted due to its minimizing manufacturing cost.…”

“…[ 210 ] PLA has a high melting point, high mechanical strength, and good strength, but poor flexibility, poor processability, and costly. [ 210 ] PLA produces by lactic acid obtained from corn fermentation; this method was recently developed and widely accepted due to its minimizing manufacturing cost. Moreover, since PLA is biocompatible, biodegradable, and extensively used in the development of medical biomaterials.…”