Study on Prevention of Postoperative Abdominal Adhesions with PLGA Nanofiber Membrane

Abstract

Objective: To evaluate the effectiveness of poly (lactic-co-glycolic acid) (PLGA) nanofiber membrane on prevention of postoperative abdominal adhesion. Methods: PLGA nanofiber membrane was prepared by high-voltage electrospinning technique. The effectiveness of the membrane in prevention of postoperative abdominal adhesions was characterized with rat abdominal adhesion models. Results: PLGA nanofiber membrane was prepared successfully by electrospinning technique. Scanning electron microscopy (SEM) observation showed that the average diameter of PLGA fibers was approximately 800 nm, and the membrane had microporous structures. Mechanical tests showed that the tensile strength of PLGA nanofiber membrane was 6.36 ± 0.39 MPa, which was significantly higher than the tensile strength of DIKANG absorbable medical film. The results of in vivo experiments showed that PLGA nanofiber membrane and DIKANG absorbable medical film could both reduce the degree of abdominal adhesions. The histological results showed that there was only a small extent of inflammatory cell infiltration in the PLGA group and the control group. The proliferation of connective tissue was reduced, and so was the degree of adhesion. Conclusion: PLGA nanofiber membrane can significantly reduce the incidence and severity of postoperative adhesions, and bodes well for future clinical applications.

A phlorotannins‐loaded homogeneous acellular matrix film modulates post‐implantation inflammatory responses

“…However, abnormally strong adhesion following a severe inflammation response and excessive fibrin accumulation may cause PPA (Chen et al, 2019). This eventually induces serious complications, such as limited joint movement, chronic pain, the need for additional surgeries, and small bowel obstruction, thereby affecting the patient's health and quality of life (Chou et al, 2017;MengQing et al, 2020). The inflammatory F I G U R E 3 Effect of Ph-cartilage acellular matrix (Ph-CAM) films on cell viability via indirect cytotoxicity analysis.…”

“…PPAs are fibrous adhesions between severely traumatized sites, such as the abdomen or other surrounding organs, which occur after abdominal and gynecological surgeries involving the flexor digitorum profundus or flexor digitorum superficialis (Chen et al., 2017; Zhou & Lu, 2020). Given that PPA incidence is estimated to exceed 80% and its recrudescence rates are even higher, PPA is a major surgical complication that must be addressed (Chen et al., 2017; MengQing et al., 2020). Adhesion and scar formation are essential components of the normal healing processes.…”

“…However, abnormally strong adhesion following a severe inflammation response and excessive fibrin accumulation may cause PPA (Chen et al., 2019). This eventually induces serious complications, such as limited joint movement, chronic pain, the need for additional surgeries, and small bowel obstruction, thereby affecting the patient's health and quality of life (Chou et al., 2017; MengQing et al., 2020). The inflammatory response promotes the migration of fibroblasts into the injury site, increases the permeability of blood vessels, and induces the increase in tissue thickness by coagulation or fibrin formation (Li et al., 2017; Nakagawa et al., 2015).…”

“…Although adhesion is an essential step during surgical wound healing, excessive progression can cause severe postoperative adhesion at the operated site, which is accompanied by several complications such as a limited range of motion, pain, loss of function, and the need for additional surgery (e.g., tenolysis and scar release) (Chou et al., 2017; Yao, Zheng, Zhang, et al., 2019). Particularly, postoperative peritendinous adhesion (PPA) is often caused by physical trauma involving the flexor digitorum profundus or flexor digitorum superficialis tendons (Chen et al., 2014; MengQing et al., 2020). PPA treatment and prevention strategies include surgery, physical barriers (e.g.…”

“…postoperative peritendinous adhesion (PPA) is often caused by physical trauma involving the flexor digitorum profundus or flexor digitorum superficialis tendons (Chen et al, 2014;MengQing et al, 2020). PPA treatment and prevention strategies include surgery, physical barriers (e.g.…”