A modern biomaterial for adhesion prevention

diZerega, Gere S.; Cortese, Stephanie; Rodgers, Kathleen E.; Block, Kathleen M.; Falcone, Samuel J.; Juarez, Thomas G.; Berg, Richard A.

doi:10.1002/jbm.b.30659

Cited by 42 publications

(39 citation statements)

References 84 publications

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“…Although there are several types of thermoresponsive anti-adhesive materials developed and studied, studies on the use after spine surgery are rare, and no material has received FDA approval [35]. Material that was used in this study is biocompatible as stated above.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of poloxamer 407-based new anti-adhesive material in a laminectomy model in rats

Lee

Baek

et al. 2011

Eur Spine J

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Purpose In the laminectomy model in rats, to verify antiadhesive effectiveness of the new material, a mixture composed of poloxamer 407, calcium chloride, and xanthorrhizol, we compared it with that of commercially used solution form anti-adhesive agent GUARDIX-SL, Biorane. Materials and methods A total of 108 Sprague-Dawley rats (SD rats) were divided equally into three groups: negative control group (NCG), positive control group (PCG), and experimental group (EG). After exposing the dura on L4 level, we closed the wound shortly after hemostasis, after administering the anti-adhesive agent. To evaluate effectiveness, 18 SD rats from each group were killed after 1 week of rearing. Nine were examined by grading of gross adhesion and the other nine, by grading of histological adhesion. The degree of adhesion in the remainder of 18 SD rats in each group was examined with the same method after four weeks of rearing.Results Comparing the degree of adhesion after growth for 1 week, the gross and histological adhesion of the EG was lower than that of the NCG. There was no statistical significance in the gross score (P = 0.63), but there was statistical significance in the histological score (P = 0.04). The EG showed similar or improved degrees of adhesion in comparison with the PCG. In comparison after growth for 4 weeks, although gross adhesion of the EG was not significantly lower than the NCG, histological adhesion was remarkably low in the EG (P = 0.01). The EG showed similar or improved degrees of gross and histological adhesion in comparison to that of the PCG. (P = 0.20, 0.07). Conclusion The new anti-adhesive material showed similar or improved effectiveness with the existing agents for commercial use. This result suggests that the new antiadhesive material will be a successful candidate as a future product for clinical use.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of poloxamer 407-based new anti-adhesive material in a laminectomy model in rats

Lee

Baek

et al. 2011

Eur Spine J

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Section: Introductionmentioning

confidence: 99%

“…Artificial materials used in neurosurgical procedures can cause a disadvantageous granulomatous process [1]. Experimental studies in recent years have also used hyaluronic acid, hemostatic gelatin (Floseal; Baxter International Inc.), DuraGen, monoclonal antibodies, mitomycin and aprotinin, TachoComb, bioresorbable films and hydrogels [3,5,7,8,19,22,25,34,40].On the other hand, following the Central Nervous System damages the glial scar formation is a reactive cellular process involving astrogliosis [13] and it is the mechanism to protect and begin the healing process in the nervous system. It is known that the absence of the glial scar has been associated with impairments in the repair of the BBB (blood brain barrier) [9].…”

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confidence: 99%

Original article Nanofiber nets in prevention of cicatrisation in spinal procedures. Experimental study

Andrychowski¹,

Frontczak-Baniewicz²,

Sulejczak³

et al. 2013

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Folia Neuropathologica 2013; 51/2 147 Nanofiber nets in prevention of cicatrisation in spinal procedures. Experimental study J Ja ar ro os sł ła aw w A An nd dr ry yc ch ho ow ws sk ki i 1 1, ,2 2 , , M Ma ał łg go or rz za at ta a F Fr ro on nt tc cz za ak k--B Ba an ni ie ew wi ic cz z A b s t r a c t Excessive cicatrisation or epidural fibrosis in the operative field is an inappropriate event occasionally occurring after neurosurgical procedures (i.e., spine procedures and craniotomies). This excessive process may disturb the postoperative course and render reoperations more difficult and risky. The literature describes this phenomenon as accompanying up to 20% of neurosurgical procedures. The scar tissue that forms postoperatively adheres to the dura mater, penetrates into the spinal canal and can cause narrowing symptoms, neurological deficits and pain. The incidence and spread of this excessive scar or epidural fibrosis can be prevented through the modification of the surgical technique by incorporating endoscopic or microscopic access to minimize the operative field and the use of isolating substances (autogenous or heterogeneous) administered intraoperatively. The aim of this experimental study was to morphologically assess the cicatrisation process, adhesion and to prevent excessive scar formation with the local use of membranes manufactured by an electrospinning process (nanotechnology). We also investigated whether the biodegradable nanofibrous net triggers or modifies the immunological response or the local inflammatory process. Micro-nanofibrous membranes were produced by the electrospinning process. A biodegradable, medically certified copolymer poly(L-lactide-co-caprolactone) (PLCL) was IntroductionThe first papers on cicatrisation or the process of epidural fibrosis after neurosurgical procedures date back to the 1970s [4,26,27,43]. Developments and progress in the field of spinal surgery have caused the number of patients undergoing these procedures to multiply [4]. Long-term postoperative observations have demonstrated excessive cicatrisation within the spinal canal and its dural and neural components to be one of the factors adversely affecting the postoperative period [10,26,28,30,41,42]. We observed this improper cicatrisation involving the neural elements after the dura and arachnoid matter damage in the different neurosurgical procedures. Epidural fibrosis is considered to be one of the mechanisms that may be responsible for postoperative pain [30,41,42]. Cicatrisation is a part of the natural and normal healing process that makes any surgery possible, but excessive or inappropriate scar formation is an adverse process in the surgical context.In neurosurgery, excessive cicatrisation can lead to neurological symptoms and pain. Its prevention is based on three methods specifically designed to significantly reduce epidural fibrosis, adhesion and/or excessive cicatrisation. The first method is based on minimizing the surgical field exposure using microscopic and endoscopic approaches [16,27...

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“…Among the materials tested are nonabsorbable solid materials (e g., amniotic membrane), solids that become absorbable by liquefying after a period of time (e.g., hyaluronic acid), and liquids (e.g., methylene blue) [13][14][15]. All of these materials are easily applied, relatively cheap, and suitable for peritoneal physiology [16]. Of these mechanical barriers, gelatinous liquids with high viscosity have been found more beneficial.…”

Section: Discussionmentioning

confidence: 99%