Cross-linked hyaluronate hydrogel prevents adhesion formation and reformation in mouse uterine horn model

Abstract

The aim of this study was to evaluate the efficacy of cross-linked hyaluronate hydrogel (HA gel) as an adjuvant for postoperative adhesion prevention, in a mouse uterine horn model. In experiment 1 uterine horns were abrased with iodine. HA gel was applied to the injured surface before closure in the treatment group. In experiment 2, after injuring the uterine horns, three stitches were placed at equal distances around the uterine horns to appose the injured medial surfaces of the two horns during healing. HA gel was inserted between the uterine horns in the treatment group. In experiment 3 prevention of adhesion reformation was assessed. After lysis of adhesions that were induced as in experiment 2, HA gel was introduced between the serosal surfaces of apposing uterine horns. Untreated animals served as controls in each experiment. Statistical analysis was carried out using Student's t-test. The adhesion score was significantly lower in the HA gel group on the 14th day compared with controls in all the experiments: in experiment 1, 0.3 +/- 0.4 versus 1.7 +/- 1.2; in experiment 2, 0.9 +/- 1.0 versus 2.6 +/- 0.5; and in experiment 3, 1.5 +/- 0.9 versus 2.2 +/- 0.6 respectively. Cross-linked HA gel significantly reduced de-novo adhesions (P< 0.03) and adhesion reformation (P < 0.03).

Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies

“…However, loss of specific functional groups in tissue interaction minimizes tissue adhesiveness after cross-linking procedure [233]. Crosslinked HA hydrogel is reported to reduce post-operative adhesion prevention in a mouse uterine horn model [234], whereas a recent human study found the gel to reduce intrauterine adhesion formation [235]. It has been suggested that semi-interpenetrating polymer networks of certain natural polymer combinations can be a solution that compensates for the shared problem of natural polymers [236].…”

Introductory Chapter: Multi-Aspect Bibliographic Analysis of the Synergy of Technical, Biological and Medical Sciences Concerning Materials and Technologies Used for Medical and Dental Implantable Devices

“…Hydrogels were used for reconstruction of the retina [523], ligament [524], fatty tissue [465], kidneys [525], muscles [526], blood vessels [527,528], and also heart, neural cells, invertebral discs, bones and gristle [459]. Hydrogels were used to prevent adhesions [529,530,531], to promote cellular adhesion [490,532,533]. So-called strong hydrogels were developed to improve mechanical properties [534].…”

Carbon dioxide pneumoperitoneum, intraperitoneal pressure, and peritoneal tissue hypoxia: a mouse study with controlled respiratory support

“…In several groups, adhesions were developed by first causing bleeding followed by suturing of the uterine horn to the peritoneal wall [26,27]. Indeed, one group reported that adhesion formation was guaranteed in mice only if hemorrhage was combined with apposition of the injured surfaces with stitches [28].…”