title: Prevention of postsurgery-induced abdominal adhesions by electrospun bioabsorbable nanofibrous poly(lactide-co-glycolide)-based membranes.
abstract: OBJECTIVE
  The objective of this study was to evaluate the efficacy of nonwoven bioabsorbable nanofibrous membranes of poly(lactideco-glycolide) for prevention of postsurgery-induced abdominal adhesions.
  
  
  BACKGROUND
  Recent reports indicated that current materials used for adhesion prevention have only limited success. Studies on other bioabsorbable materials using a new fabrication technique demonstrated the promising potential of generating an improved and inexpensive product that is suitable for a variety of surgical applications.
  
  
  METHODS
  All rats underwent a midline celiotomy. The cecum was identified and scored using an abrasive pad until serosal bleeding was noted on the anterior surface. A 1 x 1 cm of abdominal wall muscle was excised directly over the cecal wound. The celiotomy was then closed in 2 layers immediately (control) after a barrier was laid in between the cecum and the abdominal wall. All rats underwent a second celiotomy after 28 days to evaluate the extent of abdominal adhesions qualitatively and quantitatively.
  
  
  RESULTS
  Cecal adhesions were reduced from 78% in the control group to 50% in the group using biodegradable poly(lactide-co-glycolide) (PLGA) nonwoven nanofibrous membranes (n = 10, P = 0.2) and to 22% in the group using membranes containing PLGA and poly(ethylene glycol)/poly(D,L-lactide) (PEG-PLA) blends (n = 9, P = 0.03). Electrospinning method also enabled us to load an antibiotic drug Cefoxitin sodium (Mefoxin; Merck Inc., West Point, PA) with high efficacy. The electrospun PLGA/PEG-PLA membranes impregnated with 5 wt% cefoxitin sodium, which amounts to approximately 10% of the systemic daily dose typically taken after surgery in humans, completely prevented cecal adhesions (0%) in rats.
  
  
  CONCLUSIONS
  Electrospun nonwoven bioabsorbable nanofibrous membranes of poly(lactide-co-glycolide) were effective to reduce adhesions at the site of injury using an objective rat model. The membrane acted as a physical barrier but with drug-delivery capability. The combined advantages of composition adjustment, drug-loading capability, and easy placement handling (relatively hydrophobic) make these membranes potentially successful candidates for further clinical evaluations.
authors.affiliation: Department of Chemistry, Stony Brook University, Stony Brook, New York 11794-3400, USA.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Zong
authors.forename: Sean
authors.initials: S
authors.lastname: Li
authors.forename: Elliott
authors.initials: E
authors.lastname: Chen
authors.forename: Barbara
authors.initials: B
authors.lastname: Garlick
authors.forename: Kwang-Sok
authors.initials: KS
authors.lastname: Kim
authors.forename: Dufei
authors.initials: D
authors.lastname: Fang
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chiu
authors.forename: Thomas
authors.initials: T
authors.lastname: Zimmerman
authors.forename: Collin
authors.initials: C
authors.lastname: Brathwaite
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Hsiao
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chu
mesh_terms: D000005:Abdomen / Q000601:surgery*; D020341:Absorbable Implants; D000818:Animals; D002432:Cecum / Q000601:surgery; D008297:Male; D008567:Membranes, Artificial; D036103:Nanotechnology; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*
chemical_list: D008567:Membranes, Artificial; D011098:Polyglactin 910