The effect of chitosan coating on surgical sutures to strengthen the colonic anastomosis

Abstract

BACKGROUND: We evaluated the feasibility of chitosan-coated sutures for intestinal anastomosis strength through wound-healing effect. METHODS: Vicryl and PDS sutures were coated with 2% chitosan. While laparotomy was applied to the first group, chitosan was applied in the peritoneal cavity in the second group. Then the following materials were applied to colon anastomosis, in order: Vicryl, PDS, chitosan-coated Vicryl, and chitosan-coated PDS sutures. On the 7 th and 14 th days, eight rats from each group were euthanized. RESULTS: The adhesion scores of chitosan and control groups were lower than the suture groups. The vascularization of Vicryl-chitosan was lower than PDS-chitosan on the 14 th day (p=0.038). Fibroblast cells and vascularization of anastomosis with chitosan-coated Vicryl were lower than Vicryl and chitosan-coated PDS on the 14th day (p<0.05). The tensile strength of Vicryl-chitosan increased more than Vicryl in vitro (p<0.05) on the 14 th and 7 th days, but there was no difference in vivo. The tensile strength of PDS-chitosan decreased more than PDS on the 7 th day in vivo (p<0.05). CONCLUSION: The chitosan-coating effect on the adhesion and reinforcement of anastomosis in some parts of Vicryl in vitro and PDS in vivo was slightly improved.

A novel coenzyme-Q approach for the prevention of postsurgical adhesion

“…Regarding the mechanism of adhesion formation, fibrinolysis and extracellular matrix remodeling, including cell proliferation, migration, differentiation, angiogenesis, and apoptosis, are critical for the regulation of the adhesive process as controlling inflammation at initial stages (7,13,14).…”

“…Adhesions were classified by a surgeon who was unaware of the groups according to a diamond adhesion scoring system based on the evaluation of the appearance, extent, and strength of the adhesions (Table 1) (7).…”

How the Lack of Chitosan Characterization Precludes Implementation of the Safe-by-Design Concept

“…This polymer is one of the most widely used for biomedical applications. Actually, chitosan has been under investigation for drug and vaccine delivery (Borges et al, 2008;Esmaeili et al, 2010;Jafary Omid et al, 2018;Bento et al, 2019), gene delivery (Thanou et al, 2002), surgical sutures (Muzzarelli et al, 1993;Altinel et al, 2018), rebuilding of bone (Lee et al, 2009), corneal contact lenses (Silva et al, 2016), dental implants (Yokoyama et al, 2002), wound healing (Mizuno et al, 2003), antimicrobial applications (Dai et al, 2009), and tissue engineering (Madihally and Matthew, 1999;Kanimozhi et al, 2016). Moreover, chitosan has been used as a dietary supplement in preparations for treatment of obesity and hypercholesterolemia (Bokura and Kobayashi, 2003;Zhang et al, 2008) and also in medical devices for the treatment and control of bleeding (Millner et al, 2009).…”

Polymeric Nano-Biomaterials for Medical Applications: Advancements in Developing and Implementation Considering Safety-By-Design Concepts

“…This polymer is one of the most widely used for biomedical applications. Actually, chitosan has been under investigation for drug and vaccine delivery Esmaeili et al, 2010;Jafary Omid et al, 2018;, gene delivery (Thanou et al, 2002), surgical sutures (Muzzarelli et al, 1993;Altinel et al, 2018), rebuilding of bone (Lee et al, 2009), corneal contact lenses (Silva et al, 2016), dental implants (Yokoyama et al, 2002), wound healing (Mizuno et al, 2003), antimicrobial applications (Dai et al, 2009), and tissue engineering (Madihally and Matthew, 1999;Kanimozhi et al, 2016). Moreover, chitosan has been used as a dietary supplement in preparations for treatment of obesity and hypercholesterolemia (Bokura and Kobayashi, 2003; and also in medical devices for the treatment and control of bleeding (Millner et al, 2009).…”