Nanofibrous polycaprolactone/chitosan membranes for preventing postsurgical tendon adhesion

Abstract

Peritendinous adhesion is considered a major postsurgical tendon complication in hand surgery. This complication could be mitigated partially through early tendon mobilization. However, development of new treatment modalities to guide tissue regeneration and to reduce postsurgical tendon adhesion has recently gained attentions. In this article, synthesis and characterization of electrospun nanofibrous membranes (NFMs) of polycaprolactone (PCL) and chitosan to form a physical barrier against cellular migration leading to tendon adhesion is presented. The mechanical properties of the NFMs are modulated to maintain high integrity during postsurgical tendon mobilization. The tensile strength of the NFMs is examined in wet and dry conditions after 1000 cyclic pull loadings. In addition, the mechanical strength of the NFMs is evaluated after a degradation period of 30 days. To obtain NFM with desired properties, concentrations of polymer solutions, operation parameters of electrospinning and the thickness of NFMs were optimized. Based on the biodegradation and mechanical evaluations, the optimum NFM was obtained for specified amounts of PCL (5 wt %) + chitosan (2 wt %) at an electrospinning drum speed of 400 rpm. The engineered NFM could withstand forces of 33 and 19 N before and after 1000 pull cycles that are sufficient during tendon healing process. The bonding of chitosan fibers over PCL nanofibers allowed for production of NFMs with appropriate mechanical integrity and degradation rate. In vitro cell culture tests demonstrated that PCL/chitosan could only have minor impact on decreasing fibroblast attachment over the membranes probably due to protonation of amine groups.

Tendon Adhesion and Novel Solutions

“…Chitosan is another well-known polymer that can enhance the mechanical strength of NFMs when hybridized with other polymers, such as PCL, but the effect of chitosan-based NFMs against peritendinous adhesion remains controversial [147]. Although the hydrophilic nature of chitosan may partially reduce surface adhesion, other factors, including electric charge and roughness of the NFM also influences fibroblast attachment and recent studies have confirmed that PCL/chitosan NFMs had little impact on decreasing peritendinous adhesion [19, [168][169][170][171]. Meanwhile, the efficacy of loading certain particles to HA and then merging the HA-particle cargo to NFMs has also been well studied in terms of antiadhesion.…”

Oriented Fibers Cooperate with DFO to Prevent Tendon Adhesions by Improving the Repair Microenvironment

“…adhesion, resulting in severe disability, [1] which will not only seriously affect the motor function of the limbs but also increase the economic burden of individuals and society. [2] At present, the primary methods to prevent the formation of tendon adhesion are drug prevention, [3][4][5][6][7][8][9] material barrier, [10][11][12][13][14][15][16] clinical prevention, [17][18][19] and combination. [5,15,20] Among them, material barrier combined with drug prevention is the current leading research direction.…”