A review: progress in preventing tissue adhesions from a biomaterial perspective

Kheilnezhad, Bahareh; Hadjizadeh, Afra

doi:10.1039/d0bm02023k

Cited by 57 publications

(65 citation statements)

References 128 publications

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“…Adhesion formation involves a series of complex pathophysiological reactions, such as the tissue damage, inflammatory responses, coagulation, fibrin deposition, fibroblast proliferation, collagen formation, and angiogenesis ( Cannata et al, 2013 ; Kheilnezhad and Hadjizadeh, 2021 ), but the specific mechanism remains to be elucidated. Previous studies supposed that biomaterials could act as anti-adhesion barriers by blocking fibroblasts penetration ( Jiang et al, 2014 ; Chen et al, 2015b ), as the excessive proliferation of fibroblasts resulted in producing abundant collagen fibers to form dense and thick fibrous adhesions.…”

Section: Discussionmentioning

confidence: 99%

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

Wang

Peng

et al. 2021

Front. Bioeng. Biotechnol.

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Cardiovascular diseases have become a major threat to human health. The adhesion formation is an inevitable pathophysiological event after cardiac surgery. We have previously shown that gelatin/polycaprolactone (GT/PCL, mass ratio 50:50) electrospun nanofibrous membranes have high potential in preventing postoperative cardiac adhesion, but the effect of GT:PCL composition on anti-adhesion efficacy was not investigated. Herein, nanofibrous membranes with different GT:PCL mass ratios of 0:100, 30:70, 50:50, and 70:30 were prepared via electrospinning. The 70:30 membrane failed to prevent postoperative cardiac adhesion, overly high GT contents significantly deteriorated the mechanical properties, which complicated the suturing during surgery and hardly maintained the structural integrity after implantation. Unexpectedly, the 0:100 membrane (no gelatin contained) could not effectively prevent either, since its large pore size allowed the penetration of numerous inflammatory cells to elicit a severe inflammatory response. Only the GT:PCL 50:50 membrane exhibited excellent mechanical properties, good biocompatibility and effective anti-cell penetration ability, which could serve as a physical barrier to prevent postoperative cardiac adhesion and might be suitable for other biomedical applications such as wound healing, guided tissue or bone regeneration.

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Section: Discussionmentioning

confidence: 99%

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

Wang

Peng

et al. 2021

Front. Bioeng. Biotechnol.

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“…Apart from the issues related to post-operative infections, tissue adhesion is one of the main problems associated with the healing process of damaged structures [ 68 ]. It is strictly related to the imbalance between the fibrin formation and the fibrinolysis process in the inflammation process, which often develops when the basal layer of the tissue is severely damaged.…”

Section: Applicability Of Pemsmentioning

confidence: 99%

The Potential of Polyelectrolyte Multilayer Films as Drug Delivery Materials

Potaś

Winnicka

2022

IJMS

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Polyelectrolyte multilayers (PEMs) represent a group of polyelectrolyte complex (PEC)–based materials widely investigated in the biomedical and pharmaceutical sciences. Despite the unflagging popularity of the aforementioned systems in tissue engineering, only a few updated scientific reports concerning PEM potential in drug administration can be found. In fact, PEM coatings are currently recognized as important tools for functionalizing implantable scaffolds; however, only a small amount of attention has been given to PEMs as drug delivery materials. Scientific reports on PEMs reveal two dominant reasons for the limited usability of multilayers in pharmaceutical technology: complex and expensive preparation techniques as well as high sensitivity of interacting polyelectrolytes to the varieties of internal and external factors. The aim of this work was to analyze the latest approaches, concerning the potential of PEMs in pharmacy, chemical technology, and (primarily) tissue engineering, with special attention given to possible polymer combinations, technological parameters, and physicochemical characteristics, such as hydrophilicity, adhesive and swelling properties, and internal/external structures of the systems formed. Careful recognition of the above factors is crucial in the development of PEM-based drug delivery materials.

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“…It is the main unpleasant consequence of abdominal procedures. The side effect of abdominal adhesion can cause chronic and severe abdominal pain, intestinal obstruction, female infertility, and even death. − In addition, the patients make complaints about the catastrophic financial costs of the hospital readmissions. According to the postoperative tissue adhesion principle, the abnormal balance occurs between the fibrinolysis system and fibrin formation when a severe injury exists on the abdominal walls.…”

Section: Introductionmentioning

confidence: 99%

“…More mesothelium cells are removed, after which the inflammation system is commenced. A low number of mesothelium cannot produce enough tissue plasminogen activators (t-PA) and urokinase plasminogen activators (u-PA) for degrading fibrin fibers, which are formed by fibroblasts during wound healing and abnormal inflammation activities. ,, Herein, a fibrin bond is formed between tissues/organs. ,, …”

Section: Introductionmentioning

confidence: 99%

“…To reduce or overcome life-threatening abdominal adhesion formation, up to now, Interceed and Seprafilm have been introduced to be placed between tissue/organ instead of resurgery for cutting the fibrin bonds. , However, these two commercial products do not entirely prevent tissue adhesion and are insufficient; so, unwanted adhesion is often seen after surgery. In other words, the tissue is exposed to severe inflammation conditions and tissue adhesion probably occurs and these products are unable to hinder adhesion formation as well as control an inflamed environment. ,, On the other hand, several pharmacological agents have been used as solo therapy but could not improve the condition significantly because these drugs may alter the pharmacokinetics, cause rapid clearance of the drug from the abdominal cavity, or improperly used doses to control inflammation may lead to tissue toxicity or DNA mutation . Therefore, both pharmacological interventions such as drug delivery strategy and physical isolation are beneficial.…”

Section: Introductionmentioning

confidence: 99%

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Ibuprofen-Loaded Electrospun PCL/PEG Nanofibrous Membranes for Preventing Postoperative Abdominal Adhesion

Kheilnezhad

Hadjizadeh

2022

ACS Appl. Bio Mater.

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Electrospun nanofibrous membranes are a widely used physical barrier for reducing postoperative adhesion. However, these physical barriers could not prevent adhesion formation completely. Because a high-intensity inflammation occurs in the surgical area, the presence of relevant drugs to control such an inflammation is desperately needed. In this study, we fabricated an electrospun composite ibuprofen-loaded poly(ethylene glycol) (PEG)/polycaprolactone (PCL) nanofibrous membrane (NFM) to prevent abdominal adhesions. This membrane aimed to act as a barrier between the abdominal wall and surrounding tissues, without interrupting mass transfer and normal wound healing. Among various fabricated composite NFMs, PCL/25PEG-6% NFMs showed the lowest fiber diameter (448.8 ± 124.4 nm), the smallest pore size (<2 μm), and moderate ultimate stress and strain. The PCL/25PEG-6% NFMs had the lowest water contact angle (≈75°) and the highest drug profile release (≈80%) within 14 days. Furthermore, in vitro toxicity examination of PCL/25PEG-6% toward fibroblast cells demonstrated a cell viability of ≈82% after 3 days, proving its prolonged antiadhesion ability. In addition, the low number of adherent cells with a rounded shape and low cell proliferation on these NFMs indicated their special antiadhesive effects. Collectively, these results indicated that the PCL/25PEG-6% membrane might be a suitable barrier to prevent abdominal adhesion.

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A review: progress in preventing tissue adhesions from a biomaterial perspective

Abstract: Postoperative adhesions (POA) are one of the main problems of the patients and their common complaints. It is considered to be closely associated with the healing mechanism of the damaged...

Cited by 57 publications

References 128 publications

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

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

The Potential of Polyelectrolyte Multilayer Films as Drug Delivery Materials

Ibuprofen-Loaded Electrospun PCL/PEG Nanofibrous Membranes for Preventing Postoperative Abdominal Adhesion

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