Reduction of adhesion formation and promotion of wound healing after laminectomy by pharmacological inhibition of pro-inflammatory cytokines: an experimental study in the rat

Abstract

In a previous experiment using TNF inhibition in the rat it was accidentally found that adhesion and scar formation was reduced compared to previous experience. Wound and bone healing also seemed enhanced. The present study was conducted to assess if this observation could be verified in a controlled setting using a standardized laminectomy in the rat. Five rats received doxycycline and five other rats received saline and served as control. Macroscopic blinded evaluation 1 week after the laminectomy revealed that adhesion and scar formation was less in doxycycline-treated animals than in control animals. Wound and bone healing was found to be better in doxycycline-treated animals. The mechanisms for the observed effects cannot be fully understood but the data indicate that further research may lead to opportunities to design pharmacological modalities to reduce adhesion and scar formation, maybe in combination with suitable barriers.

The effectiveness of poloxamer 407-based new anti-adhesive material in a laminectomy model in rats

“…As concerns about adhesion and its clinical significance increased, Holtz [19] proposed a five-phase method to reduce adhesion: (1) reducing the initial inflammatory reaction and subsequent exudate release; (2) inhibiting coagulation of this exudate; (3) promoting the removal of fibrin deposition; (4) mechanically separating fibrincovered surfaces; and (5) inhibiting fibroblastic proliferation. As attempts to reduce the initial inflammatory reaction and the exudates release, various methods were used: alteration of surgical methods such as microdiscectomy [20], use of anti-inflammatory medications [21,22]. Bio and synthetic substances such as fat [3,23,24], Gel form and Avitene [21], Silastic [3], Polylactic acid [7], Gore-Tex membranes [25] were used based on a theoretical background that they can separate the nerve tissue (the dura and nerve roots) from its surrounding tissues (the paraspinal muscles and periosteum).…”

Evaluation of a series of silk fibroin protein‐based nonwoven mats for use as an anti‐adhesion patch for wound management in robotic surgery

“…Numerous anti‐adhesion products have been introduced into the commercial market involving pharmacological inhibition and barrier prevention . However, none are composed of natural materials except hyaluronic acid.…”

Effects of doxycycline on mesenchymal stem cell chondrogenesis and cartilage repair

“…In a study using a rat laminectomy defect model, rats that received intra-peritoneal doxycycline showed enhanced wound healing, potentially due to reduction of scar tissue formation 25 . In another study, oral doxycycline was shown to inhibit MMP and improve and the strength of rotator cuff repairs in rats 26 .…”