Division of Medical Life System, Department of Life and Medical Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyotanabe, Kyoto 610-0321, Japan.
J Biomed Mater Res B Appl Biomater. 2013 Jan;101(1):99-109. doi: 10.1002/jbm.b.32821. Epub 2012 Oct 17.
To generate a more effective and safer anti-adhesive material, we have developed a new type of thermally cross-linked gelatin film. In this study, we preclinically examined the anti-adhesive efficacy of this film and evaluated the possibility applying the film safely onto fresh intestinal anastomoses, compared with hyaluronate and carboxymethyl-cellulose (HA/CMC) film. Using a canine adhesion model, the degree of adhesion for each film was evaluated by adhesion scoring systems and histological observation. Three weeks after surgery, only the gelatin film showed significantly superior anti-adhesive effects compared to the control (no treatment), in particular, exhibiting excellent re-peritonization. Next, in a canine anastomosis model, the anastomoses were wrapped directly by each film and the bursting pressures of the anastomoses were examined 3 and 7 days after surgery. The gelatin film did not significantly affect either the bursting pressures or the healing process, compared with the control. However, the HA/CMC film significantly decreased the bursting pressures measured at 3 days after surgery. In conclusion, the thermally cross-linked gelatin film had satisfactory anti-adhesive effects with excellent re-peritonization. It could be safely applied to intestinal anastomoses without decreasing the bursting pressures. The gelatin film is considered to be quite favorable as an anti-adhesive material.
为了开发出更有效、更安全的防粘连材料，我们研制了一种新型的热交联明胶膜。在本研究中，我们对该膜的防粘连效果进行了临床前评估，并与透明质酸钠/羧甲基纤维素（HA/CMC）膜进行了比较，评估了将该膜安全应用于新鲜肠吻合口的可能性。使用犬粘连模型，通过粘连评分系统和组织学观察评估了每种膜的粘连程度。术后 3 周，与对照组（未治疗）相比，只有明胶膜表现出明显优越的防粘连效果，特别是表现出极好的腹膜再覆盖。接下来，在犬吻合模型中，直接用每种膜包裹吻合口，并在术后 3 天和 7 天检查吻合口的爆破压力。与对照组相比，明胶膜对吻合口的爆破压力或愈合过程没有显著影响。然而，HA/CMC 膜在术后 3 天测量的爆破压力显著降低。总之，热交联明胶膜具有良好的防粘连效果，腹膜再覆盖良好。它可以安全地应用于肠吻合而不会降低爆破压力。明胶膜被认为是一种很有前途的防粘连材料。
