In vivo performance of a bilayer wrap to prevent abdominal adhesions

Abstract

There is a high prevalence of intra-abdominal adhesions following bowel resection which can result in chronic pain, bowel obstruction, and morbidity. Although commercial adhesion barriers have been widely utilized for colonic resections, these barriers do not prevent anastomotic leakage resulting from reduced healing of the anastomosis which can result in long-term health problems. To address this limitation, we have developed an adhesive bilayer wrap with selective bioactivity to simultaneously prevent intra-abdominal adhesion formation and promote anastomotic healing. Reactive electrospinning was used to generate a crosslinked gelatin mesh to serve as a cellinstructive substrate to improve anastomotic healing. A coating of poly(ethylene glycol) (PEG) foam was applied to the bioactive mesh to generate an antifouling layer and prevent abdominal adhesions. After in vitro confirmation of selective bioactivity, the composite wrap was compared after 2 weeks to a commercial product (Interceed®) in an in vivo rat colonic abrasion model for prevention of intra-abdominal adhesions. The composite bilayer wrap was able to prevent intraabdominal adhesions when clinical placement was maintained. The composite bilayer wrap was further modified to include tissue adhesive properties for improved efficacy. Preliminary studies indicated that the adhesive composite bilayer wrap maintained a maximum shear strength comparable to Interceed® and greater than fibrin glue. Overall, this work resulted in an initial proof-of-concept device that was shown to effectively prevent adhesion formation in vivo. The

Gradient Modulus Tissue Adhesive Composite for Dynamic Wound Closure

“…Similar layer by layer strategies were reported for the design of advanced patches for wound management. [44][45][46][47][48] A bilayer adhesive wrap was developed with selective bioactivity to simultaneously prevent intraabdominal adhesion and promote anastomotic healing. [44] Doublelayer Janus films [46] or multilayer bio-adhesive patches [47] with a biofouling resistant outer surface were designed for strong adhesion wet tissue surfaces.…”

“…[44][45][46][47][48] A bilayer adhesive wrap was developed with selective bioactivity to simultaneously prevent intraabdominal adhesion and promote anastomotic healing. [44] Doublelayer Janus films [46] or multilayer bio-adhesive patches [47] with a biofouling resistant outer surface were designed for strong adhesion wet tissue surfaces. Recently, an off-the-shelf multilayer patch was reported for sealing gastric tissue defects, [48] which was composed of a nonadhesive top layer as the mechanical reinforcement and a dry bioadhesive bottom layer for robust adhesion on gastric tissue.…”

Overview of Tissue Engineering and Drug Delivery Applications of Reactive Electrospinning and Crosslinking Techniques of Polymeric Nanofibers with Highlights on Their Biocompatibility Testing and Regulatory Aspects

“…The wrap initially showed promise in avoiding surgical adhesions, and it was determined that it could do so while also reducing adhesions and enhancing anastomotic healing. Creating a therapeutic strategy that simultaneously deals with anastomotic leakage and intra-abdominal adhesions can significantly enhance patient results and lessen the need for extended hospital stays and additional surgeries [ 133 ].…”

“…GNP was added, which improved thermal conductivity, avoided delamination problems, and increased mechanical strength. These graded membranes demonstrated the potential for customized drug delivery systems, demonstrating a multimodal drug-release pattern by releasing CHX quickly at first and maintaining consistent release over time [ 133 ].…”

Recent Advances in Engineering Bioinks for 3D Bioprinting

“…Additionally, owing to the inherent non‐fouling properties, PEG‐based hydrogels can be used to prevent abdominal adhesions. [ 90 ] PEG has been widely used in 3D bioprinting. Ma et al used a mixture of PEG, gelatin methacrylate, alginate, and interferon‐γ to manufacture a scaffold with immunomodulatory function, which could induce the polarization of M1 macrophages and successfully improve vascular germination, neovascular maturation, and vascular bone regeneration.…”