Lin Long-Xiang, Luo Jing-Wan, Yuan Fang, Zhang Hui-Hui, Ye Chen-Qing, Zhang Peng, Sun Yu-Long
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Fujian Province University Key Laboratory of Green Energy and Environment Catalysis, Ningde Normal University, Ningde 352100, PR China.
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
Mater Sci Eng C Mater Biol Appl. 2017 Dec 1;81:380-385. doi: 10.1016/j.msec.2017.07.024. Epub 2017 Jul 18.
Postoperative intra-abdominal adhesion often causes many complications. Chitosan fluid has been used in clinic to prevent intra-abdominal adhesion. However, fluid can be easily diluted and cannot stay on the wound site. As hydrogel is able to form stable physical barrier to separate injured tissues, we developed a chitosan hydrogel for better prevention of intra-abdominal adhesion in this study.
We synthesized a carbodiimide-derivatized chitosan gelatin (cd-CS-gelatin) hydrogel and investigated its rheological properties. A rat model was used to compare the anti-adhesion effect of chitosan hydrogel and fluid. The wounds were created with damage of the underlying muscle of the abdominal wall and the serosal layer of the cecum. They were coated with chitosan fluid or cd-CS-gelatin hydrogel. At day 14 after surgery, the animals were euthanized and intra-abdominal adhesion was assessed.
The cd-CS-gelatin hydrogel solidified within 3min after the mixing of the reagents. The cecum-abdomen adhesion occurred in all rats without anti-adhesion treatment. The application of cd-CS-gelatin significantly reduced the adhesion rate from 100% to 50%, compared the chitosan fluid only to 88%. The decrease of adhesion breaking strength also manifested that cd-CS-gelatin was more effective than chitosan fluid to reduce postsurgical intra-abdominal adhesion formation.
Chitosan hydrogel is more effective than chitosan fluid to prevent postoperative cecum-abdomen adhesion. It indicates that hydrogel could be a more promising state than liquid to prevent postoperative intra-abdominal adhesion.
术后腹腔粘连常引发多种并发症。壳聚糖液已在临床上用于预防腹腔粘连。然而，液体容易被稀释，无法停留在伤口部位。由于水凝胶能够形成稳定的物理屏障来分隔受损组织，因此在本研究中我们开发了一种壳聚糖水凝胶以更好地预防腹腔粘连。
我们合成了一种碳二亚胺衍生化壳聚糖明胶（cd-CS-明胶）水凝胶，并研究了其流变学特性。使用大鼠模型比较壳聚糖水凝胶和液体的抗粘连效果。通过损伤腹壁下层肌肉和盲肠浆膜层来制造伤口。分别用壳聚糖液或cd-CS-明胶水凝胶覆盖伤口。术后第14天，对动物实施安乐死并评估腹腔粘连情况。
试剂混合后3分钟内，cd-CS-明胶水凝胶凝固。所有未进行抗粘连治疗的大鼠均发生了盲肠-腹部粘连。与仅使用壳聚糖液时粘连率为88%相比，应用cd-CS-明胶可使粘连率从100%显著降低至50%。粘连破坏强度的降低也表明，在减少术后腹腔粘连形成方面，cd-CS-明胶比壳聚糖液更有效。
壳聚糖水凝胶在预防术后盲肠-腹部粘连方面比壳聚糖液更有效。这表明在预防术后腹腔粘连方面，水凝胶可能比液体更具前景。
