Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, China; Shanghai Pediatric Congenital Heart Disease Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai 200127, China; Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, 250 Longwood Avenue, Boston, MA 02115, USA.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.
Acta Biomater. 2019 Jan 1;83:211-220. doi: 10.1016/j.actbio.2018.10.022. Epub 2018 Oct 31.
Post-cardiac surgical sternal and epicardial adhesions increase the risk and complexity of cardiac re-operative surgeries, which represent a significant challenge for patients with the congenital cardiac disease. Bioresorbable membranes can serve as barriers to prevent postoperative adhesions. Herein, we fabricated a bioresorbable gelatin/polycaprolactone (GT/PCL) composite membrane via electrospinning. The membrane was characterized in terms of morphology, mechanical properties, and biocompatibility. We then evaluated its efficacy as a physical barrier to prevent cardiac operative adhesions in a rabbit model. Our results showed that the membrane had a nanofibrous structure and was sturdy enough to be handled for the surgical procedures. In vitro studies with rabbit cardiac fibroblasts demonstrated that the membrane was biocompatible and inhibited cell infiltration. Further application of the membrane in a rabbit cardiac adhesion model revealed that the membrane was resorbed gradually and effectively resisted the sternal and epicardial adhesions. Interestingly, six months after the operation, the GT/PCL membrane was completely resorbed with simultaneous ingrowth of host cells to form a natural barrier. Collectively, these results indicated that the GT/PCL membrane might be a suitable barrier to prevent sternal and epicardial adhesions and might be utilized as a novel pericardial substitute for cardiac surgery. STATEMENT OF SIGNIFICANCE: Electrospinning is a versatile method to prepare nanofibrous membranes for tissue engineering and regenerative medicine applications. However, with the micro-/nano-scale structure and high porosity, the electrospun membrane might be an excellent candidate as a barrier to prevent postoperative adhesion. Here we prepared an electropun GT/PCL nanofibrous membrane and applied it as a barrier to prevent sternal and epicardial adhesions. Our results showed that the membrane had sufficient mechanical strength, good biocompatibility, and effectively resisted the sternal and epicardial adhesions. What's more, the membrane was bioresorbable and allowed simultaneous ingrowth of host cells to form a natural barrier. We believe that the current will inspire more research on nanomaterials to prevent postoperative adhesion applications.
心脏手术后胸骨和心外膜粘连增加了心脏再次手术的风险和复杂性，这对先天性心脏病患者来说是一个重大挑战。生物可吸收膜可作为防止术后粘连的屏障。在此，我们通过静电纺丝制备了一种生物可吸收的明胶/聚己内酯（GT/PCL）复合膜。该膜的形态、力学性能和生物相容性进行了表征。然后，我们在兔模型中评估了其作为物理屏障防止心脏手术粘连的效果。我们的结果表明，该膜具有纳米纤维结构，足够坚固，可用于手术操作。兔心脏成纤维细胞的体外研究表明，该膜具有生物相容性，并抑制细胞浸润。进一步将该膜应用于兔心脏粘连模型表明，该膜逐渐被吸收，并有效地抵抗胸骨和心外膜粘连。有趣的是，手术后六个月，GT/PCL 膜完全被吸收，同时宿主细胞向内生长形成天然屏障。总的来说，这些结果表明 GT/PCL 膜可能是一种预防胸骨和心外膜粘连的合适屏障，并可能被用作心脏手术的新型心包替代物。
静电纺丝是一种用于组织工程和再生医学应用的多功能方法，可制备纳米纤维膜。然而，由于其微/纳米级结构和高孔隙率，静电纺丝膜可能是一种预防术后粘连的优秀候选物。在这里，我们制备了一种电纺 GT/PCL 纳米纤维膜，并将其用作预防胸骨和心外膜粘连的屏障。我们的结果表明，该膜具有足够的机械强度、良好的生物相容性，并有效地抵抗胸骨和心外膜粘连。更重要的是，该膜是可生物吸收的，并允许宿主细胞同时向内生长形成天然屏障。我们相信，这将激发更多关于纳米材料的研究，以应用于预防术后粘连。
