Zong Xinhua, Li Sean, Chen Elliott, Garlick Barbara, Kim Kwang-Sok, Fang Dufei, Chiu Jonathan, Zimmerman Thomas, Brathwaite Collin, Hsiao Benjamin S, Chu Benjamin
Department of Chemistry, Stony Brook University, Stony Brook, New York 11794-3400, USA.
Ann Surg. 2004 Nov;240(5):910-5. doi: 10.1097/01.sla.0000143302.48223.7e.
The objective of this study was to evaluate the efficacy of nonwoven bioabsorbable nanofibrous membranes of poly(lactideco-glycolide) for prevention of postsurgery-induced abdominal adhesions.
Recent reports indicated that current materials used for adhesion prevention have only limited success. Studies on other bioabsorbable materials using a new fabrication technique demonstrated the promising potential of generating an improved and inexpensive product that is suitable for a variety of surgical applications.
All rats underwent a midline celiotomy. The cecum was identified and scored using an abrasive pad until serosal bleeding was noted on the anterior surface. A 1 x 1 cm of abdominal wall muscle was excised directly over the cecal wound. The celiotomy was then closed in 2 layers immediately (control) after a barrier was laid in between the cecum and the abdominal wall. All rats underwent a second celiotomy after 28 days to evaluate the extent of abdominal adhesions qualitatively and quantitatively.
Cecal adhesions were reduced from 78% in the control group to 50% in the group using biodegradable poly(lactide-co-glycolide) (PLGA) nonwoven nanofibrous membranes (n = 10, P = 0.2) and to 22% in the group using membranes containing PLGA and poly(ethylene glycol)/poly(D,L-lactide) (PEG-PLA) blends (n = 9, P = 0.03). Electrospinning method also enabled us to load an antibiotic drug Cefoxitin sodium (Mefoxin; Merck Inc., West Point, PA) with high efficacy. The electrospun PLGA/PEG-PLA membranes impregnated with 5 wt% cefoxitin sodium, which amounts to approximately 10% of the systemic daily dose typically taken after surgery in humans, completely prevented cecal adhesions (0%) in rats.
Electrospun nonwoven bioabsorbable nanofibrous membranes of poly(lactide-co-glycolide) were effective to reduce adhesions at the site of injury using an objective rat model. The membrane acted as a physical barrier but with drug-delivery capability. The combined advantages of composition adjustment, drug-loading capability, and easy placement handling (relatively hydrophobic) make these membranes potentially successful candidates for further clinical evaluations.
本研究的目的是评估聚（丙交酯-乙交酯）非织造生物可吸收纳米纤维膜预防术后腹部粘连的疗效。
最近的报告表明，目前用于预防粘连的材料成功率有限。对使用新制造技术的其他生物可吸收材料的研究表明，有潜力生产出一种改进的、廉价的产品，适用于各种外科手术应用。
所有大鼠均接受中线剖腹术。识别盲肠并用研磨垫进行评分，直到在前表面观察到浆膜出血。在盲肠伤口上方直接切除1×1cm的腹壁肌肉。然后在盲肠和腹壁之间放置屏障后立即分两层关闭剖腹术（对照组）。28天后，所有大鼠均接受第二次剖腹术，以定性和定量评估腹部粘连的程度。
使用可生物降解的聚（丙交酯-乙交酯）（PLGA）非织造纳米纤维膜的组（n = 10，P = 0.2），盲肠粘连从对照组的78%降至50%；使用含有PLGA和聚（乙二醇）/聚（D，L-丙交酯）（PEG-PLA）共混物的膜的组（n = 9，P = 0.03），盲肠粘连降至22%。静电纺丝法还使我们能够高效负载抗生素头孢西丁钠（美福仙；默克公司，西点，宾夕法尼亚州）。浸渍有5 wt%头孢西丁钠的静电纺PLGA/PEG-PLA膜，相当于人类术后通常服用的全身日剂量的约10%，可完全预防大鼠的盲肠粘连（0%）。
使用客观的大鼠模型，聚（丙交酯-乙交酯）静电纺非织造生物可吸收纳米纤维膜可有效减少损伤部位的粘连。该膜起到物理屏障的作用，但具有药物递送能力。成分调整、载药能力和易于放置处理（相对疏水）的综合优势使这些膜有可能成为进一步临床评估的成功候选者。
