Prevention of retrosternal adhesion by novel biocompatible glue derived from food additives

Abstract

Our findings indicate that Lydex reduces retrosternal adhesion and attenuates the progression of fibrosis with excellent biocompatibility. Lydex is a next-generation substance for safer cardiac reoperation, with excellent capability for preventing adhesion, biocompatible and biodegradable properties, and lower potential for viral infections related to human plasma or other animal-derived products.

Management of retrosternal adhesion after median sternotomy by controlling degradation speed of a dextran and ε-poly (l-lysine)-based biocompatible glue

“…Another possibility would be the existence of other factors than the retainment of Lydex which can affect the macrophage infiltration, and the factors should be further investigated in our future studies. The results from Lydex 1 and 3 groups were comparable with our previous report in which Lydex was loaded at the retrosternal space of rabbits [6]. In the study, macrophage counts after loading of Lydex was comparable with that of unloaded control, whereas a significant increase of macrophage infiltration was observed in ePTFE-placed animals.…”

“…Preventative strategies to minimize the risk have been cumulated by surgeons so far including pre-operative imaging with computed tomography [13], establishment of cardiopulmonary bypass before resternotomy via femoral cannulation [12] and specialized devices for the dissection of retrosternal adhesion such as video-assisted retrosternal dissection system using Mayfield resternotomy retractor [14]. Placement of prosthetic materials such as Dacron/ePTFE [15] or bioresorbable barrier films [3] to prevent the progression of retrosternal adhesion is reported to hold negligible clinical benefits [6] whereas a certain risk of foreign body-mediated retrosternal inflammation exists. In the present study, we have reported the potential of a biodegradable glue, Lydex as an alternative to reduce the risk of resternotomy which can be easily loaded at the timing of initial sternal closure.…”

“…We have previously reported a novel biocompatible glue named "Lydex" [6][7][8]. Lydex is a biodegradable glue derived from dextran and ε-poly (l-lysine), food additives commonly used in our daily life without healthcare problems and are approved by the US Food and Drug Administration.…”

“…Lydex is a biodegradable glue derived from dextran and ε-poly (l-lysine), food additives commonly used in our daily life without healthcare problems and are approved by the US Food and Drug Administration. In our rabbit median sternotomy model, Lydex could efficiently reduce retrosternal adhesion through the attenuation of the infiltration of macrophages and progression of fibrosis compared to animals implanted with expanded polytetrafluoroethylene (ePTFE), indicating an excellent biocompatibility of Lydex [6,9].…”

Degradable Adhesives for Surgery and Tissue Engineering

“…They were shown to have high bonding strength and degradability along with low cytotoxicity. Hyon and co-workers successfully applied these adhesives in lung surgeries, laparoscopic partial nephrectomy, ocular reconstruction, cartilage or bone regeneration, cardiovascular surgery, and as a drug or gene carrier agent. − High aldehyde concentrations are detrimental to tissue and may result in tissue inflammation or tissue necrosis. It is therefore necessary to monitor the aldehyde concentration in the adhesives to avoid cytocompatibility issues.…”