Alginate Film as a Novel Post-Surgical Tissue Adhesion Barrier

Abstract

In this study, we focused on alginate as a physical tissue adhesion barrier material. The alginate has a muco-adhesive property in the solid state and becomes a viscous slippery gel-like solution in the dissolved state. We hypothesized that the alginate film without cross-linking can be a good candidate as a tissue adhesion barrier. The un-cross-linked alginate film may stably adhere onto a wound owing to its muco-adhesive property and, thus, does not need suturing to fix it, and then the film may slowly change into a slippery gel by hydration when in contact with body fluid and, thus, effectively separate the wound from the surrounding tissue without adhesion. To verify our hypothesis, we fabricated a un-cross-linked alginate film and its potential as a tissue adhesion barrier was evaluated through the comparison with various types of alginate (viscous solution and gel as well as cross-linked film) and a commercialized tissue adhesion barrier, Interceed, by the investigation of post-surgical peritoneal adhesion using a rat model. From the animal study, it was observed that the un-cross-linked alginate film was more effective for the prevention of peritoneal tissue adhesion than other types of alginates, including the commercialized one, probably owing to its unique muco-adhesive property (providing residence stability without suturing at the injured site) and lubricant property (by hydration in contact with body fluid) during wound healing. The un-cross-linked alginate film also showed a low inflammatory response and did not lead to specific histological influence during the wound healing. From these observations, the un-cross-linked alginate film is expected to be a simple and efficient tissue adhesion barrier applicable to various injury tissues.

Evaluation of 4DryField® PH as Adhesion Prevention Barrier Tested in an Optimized Adhesion Model in Rats

“…As compared to results recently published in the literature using Adept® (Baxter Healthcare Corporation, USA) [28,29,30,31,32,33], Interceed® (Ethicon, Inc., USA) [25,27,29,34,35,36,37,38,39], and Seprafilm® (Genzyme Corporation, USA) [26,27,31,34,38,39,40,41,42,43,44] in rat models, the results obtained with 4DryField PH in this study are in the upper range of benefit and are comparable with the data of Kaptanoglu et al [43] and Wallwiener et al [29]. …”

Prevention of intrauterine post-surgical adhesions in hysteroscopy. A systematic review

“…Alginate, already used as a wound dressing agent, has hemostatic and antimicrobial effects in its calcium or sodium form, and has been shown to prevent adhesion formation in animal studies [47,48]. ACH had a comparable efficacy to CH in terms of adhesion rate and severity, although, in the case of no prior IUA, intrauterine application of ACH after hysteroscopic surgery resulted in lower de novo IUA compared with CH.…”

Quantitative Tissue Spectroscopy of Near Infrared Fluorescent Nanosensor Implants

“…Alginate, the most widely used material for microbead formation 36 , is a naturally occurring anionic polysaccharide derived from brown algae that also has desirable properties for SWNT encapsulation. Alginate has been approved for wound dressings and as a cell carrier due to its lack of toxicity 37–39 , however it has been found that the ionically bonded hydrogels frequently suffer from degradation, unable to endure the mechanical and chemical strain of implantation and the exchange of cations that occurs under physiological conditions 36,40,41 . Although ionically crosslinked alginate gels can undergo uncontrollable biodegradation while releasing polysaccharide chains from their matrix 42 , partial control can be obtained by bimodal molecular weight distribution of the polymer building blocks 43 .…”