Chung Young Soo, Park Si-Nae, Ko Jae Hyung, Bae Sang Hee, Lee Song, Shim In Kyong, Kim Song Cheol
Department of Surgery, Pusan National University School of Medicine & Pusan National University Hospital, Busan, South Korea.
Regenerative Medicine Research Center, DalimTissen Co., LTD., Seoul, South Korea.
J Surg Res. 2016 Oct;205(2):341-349. doi: 10.1016/j.jss.2016.06.095. Epub 2016 Jul 5.
Collagen exhibits ideal multifactorial action for preventing tissue adhesions. This study examined the efficacy of ionized collagen in preventing tissue adhesion after surgical procedures.
Ionized collagen was prepared using the esterification technique of natural collagen. Three forms of collagen materials (membrane, film, and gel) were compared with three commercialized materials (oxidized regenerated cellulose membrane [OC membrane], hyaluronic acid and carboxymethylcellulose film, and gel [HC film and HC gel]) in a rat cecum abrasion model. Antiadhesive activity and histologic findings were assessed.
The incidence of adhesion was reduced significantly in all test groups compared to the sham-operated control group (100% in control, 14.3% in collagen membrane, 63.6% in collagen film, 25.0% in collagen gel, 55.6% in OC membrane, 75% in HC film, and 83.3% in HC gel). All collagen materials of the three forms exhibited a significant reduction in adhesion grade compared with the sham operation, whereas no significant difference was found among these three different forms. The collagen membrane showed significantly less adhesion grade, less inflammation and more regenerative features compared to widely used conventional materials.
This preclinical investigation indicated that ionized collagen materials readily formed clinically suitable shapes for easy handling without the need for any complex processing and effectively reduced postoperative tissue adhesion profiles compared to conventional antiadhesive agents.
胶原蛋白在预防组织粘连方面具有理想的多因素作用。本研究考察了离子化胶原蛋白在外科手术后预防组织粘连的效果。
采用天然胶原蛋白的酯化技术制备离子化胶原蛋白。在大鼠盲肠擦伤模型中，将三种形式的胶原蛋白材料（膜、片和凝胶）与三种商品化材料（氧化再生纤维素膜[OC膜]、透明质酸和羧甲基纤维素片及凝胶[HC片和HC凝胶]）进行比较。评估抗粘连活性和组织学结果。
与假手术对照组相比，所有测试组的粘连发生率均显著降低（对照组为100%，胶原膜组为14.3%，胶原片组为63.6%，胶原凝胶组为25.0%，OC膜组为55.6%，HC片组为75%，HC凝胶组为83.3%）。三种形式的所有胶原蛋白材料与假手术相比，粘连等级均显著降低，而这三种不同形式之间未发现显著差异。与广泛使用的传统材料相比，胶原膜的粘连等级显著更低，炎症更少，再生特征更多。
这项临床前研究表明，离子化胶原蛋白材料易于形成临床适用的形状，便于操作，无需任何复杂加工，与传统抗粘连剂相比，能有效降低术后组织粘连情况。
