Reduction of fibrous adhesion formation by a copolymer possessing an affinity for anionic surfaces.
Postsurgical adhesions represent a common complication following a variety of surgical procedures. We sought to develop and evaluate a water-soluble polymer that could self-assemble onto tissue surfaces, forming a barrier on the surface. A copolymer was synthesized so as to contain two components: one component adsorbed to the tissue surface, and the other created a steric barrier, thereby preventing cell interactions with the tissue surface, and perhaps altering the wound-healing response that leads to the formation of fibrous adhesions. The component selected for tissue binding was a water-soluble polycation, poly-L-lysine, which can bind to negative sites on glycoproteins, proteoglycans, and cells; and the component selected for steric stabilization was polyethylene glycol, a nonionic polymer that interacts poorly with proteins. Efficacy of lavage with an aqueous solution of the copolymer for the prevention of postsurgical abdominopelvic adhesions was assessed following a standard electrocautery injury of the uterine horns of rats. The copolymer resulted in an 88% reduction in the extent of adhesions that formed. In vitro studies designed to investigate the mechanism of this efficacy indicated that the copolymer may both hinder cell-tissue adhesive interactions and alter the process of fibrin formation.
Elbert
D L
DL
Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena 91125, USA.
Hubbell
J A
JA
D000005:Abdomen; D000818:Animals; D000838:Anions; D001672:Biocompatible Materials; D002460:Cell Line; D004195:Disease Models, Animal; D005260:Female; D005337:Fibrin / Q000737:chemistry; D006868:Hydrolysis; D066298:In Vitro Techniques; D008264:Macrophages / Q000166:cytology; D010388:Pelvis; D011092:Polyethylene Glycols / Q000737:chemistry; D011107:Polylysine / Q000737:chemistry; D011183:Postoperative Complications; D051381:Rats; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*
D000838:Anions; D001672:Biocompatible Materials; D011107:Polylysine; D011092:Polyethylene Glycols; D005337:Fibrin