Evaluation of a bioabsorable polylactide film in a large animal model for the reduction of retrosternal adhesions.
OBJECTIVE
An adult pig model of retrosternal adhesion formation via an inferior hemisternotomy was used to evaluate the formation and development of pericardial and retrosternal adhesions, as well as adhesion reduction using two thicknesses of a bioabsorbable polylactide film.


METHODS
Twenty-five adult female pigs (70 kg) were allocated to either a control group or four different treatments using two thicknesses (0.02 or 0.05 mm) of a polylactide film. In each animal, the film was placed either inside the pericardium or inside and outside the pericardium.


RESULTS
All animals demonstrated adhesions between the posterior and lateral surfaces of the heart and pericardium. Thick fibrous retrosternal adhesions and pericardial adhesions were noted in the control animals with complete obliteration of the anatomical plane. The polylactide films preserved the anatomical planes and reduced the adhesion response.


CONCLUSIONS
A reproducible animal model was used to examine the formation and reduction of retrosternal and pericardial adhesions. A polylactide film placed inside the pericardium or between the heart and sternum was able to limit adhesion formation and maintain the anatomical planes, which would facilitate reentry.
Iliopoulos
J
J
Orthopaedic Research Laboratories, Division of Surgery, University of New South Wales, Prince of Wales Hospital, Sydney, Australia.
Cornwall
G B
GB
Evans
R O N
RO
Manganas
C
C
Thomas
K A
KA
Newman
D C
DC
Walsh
W R
WR
D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology*; D004195:Disease Models, Animal; D005260:Female; D010496:Pericardium / Q000473:pathology / Q000601:surgery; D011091:Polyesters / Q000494:pharmacology*; D013249:Sternum / Q000601:surgery; D013552:Swine; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
D001672:Biocompatible Materials; D011091:Polyesters; C033616:poly(lactide)