Reduction in postsurgical adhesion formation after cardiac surgery in a rabbit model using N,O-carboxymethyl chitosan to block cell adherence

Abstract

The application of N,O-carboxymethyl chitosan gel and solution significantly reduces the severity of postsurgical adhesion formation after cardiac surgery in the rabbit model. The inability of fibroblasts to adhere to N,O-carboxymethyl chitosan-coated surfaces suggests that N,O-carboxymethyl chitosan may act as a biophysical barrier.

Keratinocyte growth factor: a new mesothelial targeted therapy to reduce postoperative pericardial adhesions☆

“…The barrier methods using bio-absorbable biopolymers released in a gel composition or in a sheet layer showed good results [11,12]. These methods are in accordance with the Fig.…”

“…Heterologous pericardium [7], anti-inflammatory drugs [8], synthetic rubbers [9], fibrinolytic agents [10] and biopolymers [11,12] are examples of therapies explored for such purpose.…”

Prevention of postoperative peritoneal adhesions by O-carboxymethyl chitosan in a rat cecal abrasion model

“…This hypothesis concerning the function of O-CMC is supported by several studies. An in vitro study demonstrated that few of fibroblasts and macrophages could adhere to N,O-CMC-coated plates, 11 implying that the chitosan derivative inhibits the adhesion of inflammatory cells to the ECM of injured tissues. In another study, intranasal application of water-soluble chitosan was shown to attenuate infiltration of inflammatory cells and markedly decrease production of inflammatory cytokines such as tumor necrosis factor-α and interleukin 6.…”

“…This water-soluble chitosan derivative has been shown to reduce postoperative adhesion development, [8][9][10] which may act as a biophysical barrier and block the adherence of inflammatory cells. 11 Another chitosan derivative, O-carboxymethyl chitosan (O-CMC), developed by carboxymethylation of chitosan's oxygen centers, also exhibits remarkable water-solubility and bio-compatibility. 12 Little is known, however, of the potential of O-CMC to protect against adhesion formation.…”

Biomedical applications of carboxymethyl chitosans

“…Radiographic evidence of bone regeneration by exploiting NNDCMchitosan for the delivery of bone morphogenetic protein to bones in human patients undergoing apicectomies and avulsions was observed (Mattioli-Belmonte et al, 1999). The efficacy of NOCMchitosan to reduce post operative adhesion formation has also been demonstrated in rabbit by a cardiac injury model and an abdominal surgery model (Zhou, Liwski, Elson, & Lee, 2008).…”