Reduction in experimental peridural adhesion with the use of a crosslinked hyaluronate/collagen membrane

Abstract

The research goals were to fabricate a crosslinked hyaluronate (HA)/collagen membrane and study its efficacy in preventing peridural adhesion. Different weight ratios of HA/collagen membranes crosslinked with carbodiimide were tested for biocompatibility and biodegradability first. Forty-eight adult New Zealand white rabbits underwent an L6 laminectomy. Sixteen rabbits each received a weight ratio of HA/collagen = 60/40 membrane (Membrane A) or a 40/60 membrane (Membrane B) on the exposed dura. The last 16 rabbits received no treatment and served as controls. No adverse reaction of the membranes was noted. Magnetic resonance images revealed a hyposignal space between the dura and the scar tissues at Membrane B-treated laminectomy site 3 months after surgery. Histological examination showed that the amount of scarring decreased with time in all groups. Amount of scarring decreased significantly at laminectomy sites treated with either membrane. Compared with the control group, the extent of peridural adhesion decreased significantly in the Membrane B-treated group at 3 months after surgery; while it decreased substantially, but not significantly, in the Membrane A-treated group. The carbodiimide-crosslinked HA/collagen membrane is a safe and effective antiadhesive material in vivo. When placed onto the laminectomy site, the membrane with a weight ratio of HA/collagen = 40/60 appears to reduce peridural scar adhesion.

Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions

“…These three groups demonstrated more newly formed bone tissue in comparison with AFF group (Table 5). The results were correlated with other reports [12,29]. It is uncertain whether FAM or CAM can cause significant new bone formation in human spine because of species differences in osteogenicity.…”

“…It has been used to treat variable diseases such as non-healing skin ulcers, vaginal atresia, and severe ocular surface disease [9,35]. Moreover, it can serve as adjunctive tissue to reduce surgical adhesions in abdominal surgery and otolaryngologic surgery [25,29,36]. Furthermore, AM is an immuneprivileged tissue and rarely causes immunologic rejection [15].…”

Surface Treatment of Flexor Tendon Autografts with Carbodiimide-Derivatized Hyaluronic Acid<sbt aid="1047845">An in Vivo Canine Model</sbt>

“…The modification of hyaluronic acid with use of the carbodiimide (EDC) reaction to create new biopolymers, crosslinking with other biological molecules such as collagen, has been recently and widely investigated for applications such as anti-adhesion membranes 40,57 and biodegradable scaffolds 58,59 , for tissue regeneration, or as timed-release drug-delivery vehicles 60,61 . However, to our knowledge, we are the first to report the use of cd-HA by direct bonding to the tendon surface to improve flexor tendon grafting in vivo.…”

Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study

“…It is a regulator of many biological events; during the first stages of tissue repair, a relatively high concentration of HA in the extracellular space has been demonstrated to partially limit the extracellular matrix and collagen deposition. 28,41 Therefore, its role in preventing epidural fibrosis has been frequently investigated. Songer and colleagues 42 investigated the effects of HA in gel foam and claimed that, in their HA group, a wider distance was observed among the subarachnoid space, fibrotic tissues, and dura mater, in addition to a lower inflammatory cell count in the epidural fibrosis tissue.…”