Kishan Alysha, Buie Taneidra, Whitfield-Cargile Canaan, Jose Anupriya, Bryan Laura, Cohen Noah, Cosgriff-Hernandez Elizabeth
Department of Biomedical Engineering, Texas A&M University, College Station, TX, 77843 United States.
Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX 78712 United States.
Acta Biomater. 2020 Oct 1;115:116-126. doi: 10.1016/j.actbio.2020.08.021. Epub 2020 Aug 24.
There is a high prevalence of intra-abdominal adhesions following bowel resection, which can result in chronic pain, bowel obstruction, and morbidity. Although commercial adhesion barriers have been widely utilized for colonic resections, these barriers do not prevent anastomotic leakage resulting from reduced healing of the anastomosis, which can result in long-term health problems. To address this limitation, we have developed an adhesive bilayer wrap with selective bioactivity to simultaneously prevent intra-abdominal adhesion formation and promote anastomotic healing. Reactive electrospinning was used to generate a crosslinked gelatin mesh to serve as a cell-instructive substrate to improve anastomotic healing. A coating of poly(ethylene glycol) (PEG) foam was applied to the bioactive mesh to generate an antifouling layer and prevent intra-abdominal adhesions. After in vitro confirmation of selective bioactivity, the composite wrap was compared after 2 weeks to a commercial product (Interceed) in an in vivo rat colonic abrasion model for prevention of intra-abdominal adhesions. The composite bilayer wrap was able to prevent intra-abdominal adhesions when clinical placement was maintained. The composite bilayer wrap was further modified to include tissue adhesive properties for improved efficacy. Preliminary studies indicated that the adhesive composite bilayer wrap maintained a maximum shear strength comparable to Interceed and greater than fibrin glue. Overall, this work resulted in an initial proof-of-concept device that was shown to effectively prevent intra-abdominal adhesion formation in vivo. The composite bilayer wrap studied here could lead to an improved technology for improved healing of intestinal anastomoses.
肠切除术后腹腔内粘连的发生率很高，这可能导致慢性疼痛、肠梗阻和发病。尽管商业粘连屏障已广泛用于结肠切除术，但这些屏障并不能防止因吻合口愈合不良导致的吻合口漏，而这可能导致长期健康问题。为了解决这一局限性，我们开发了一种具有选择性生物活性的粘性双层包裹物，以同时防止腹腔内粘连形成并促进吻合口愈合。采用反应性静电纺丝法制备交联明胶网，作为细胞指导基质以改善吻合口愈合。在生物活性网上涂覆聚乙二醇（PEG）泡沫以形成防污层并防止腹腔内粘连。在体外确认选择性生物活性后，将该复合包裹物在体内大鼠结肠擦伤模型中与一种商业产品（Interceed）比较，以预防腹腔内粘连，为期2周。当保持临床放置时，复合双层包裹物能够防止腹腔内粘连。对复合双层包裹物进行进一步改良，使其具有组织粘附特性以提高疗效。初步研究表明，粘性复合双层包裹物的最大剪切强度与Interceed相当，且大于纤维蛋白胶。总体而言，这项工作产生了一种初步的概念验证装置，已证明其能在体内有效防止腹腔内粘连形成。本文研究的复合双层包裹物可能会带来一种改进技术，以促进肠吻合口的愈合。
