title: Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan.
abstract: OBJECTIVE
  The aim of this study is to evaluate CMC physical-chemical alterations after thermal sterilization and its efficacy in preventing poststernotomy pericardial adhesions.
  
  
  METHODS
  After autoclaving thermal sterilization, thermal sterile Carboxymethyl Chitosan (CMCts) was submitted to physical-chemical analysis. Twelve animals were divided into two groups and underwent pericardiotomy and adhesion induction protocol. Afterward, topic CMCts or saline solution was administered. After 8 weeks, a sternotomy was performed for adhesion score macroscopic evaluation, dissection time and the amount of recalcitrant dissection, and microscopic evaluation.
  
  
  RESULTS
  Physical-chemical analysis showed no difference between CMC and CMCts. A macroscopic analysis showed that the intensity of adhesions was significantly lower in the CMCts group (P=0.007). Dissection time and use of recalcitrant dissection also decreased significantly (P=0.007, P=0.008; respectively). Microscopic results indicated a significant reduction in the epicardium collagen area and in the total epicardium area (P=0.05) and (P=0.03).
  
  
  CONCLUSIONS
  The sterilization method did not change Carboxymethyl Chitosan physical-chemical properties. Using barrier biopolymer, such as CMCts, can decrease the intensity of pericardium postoperative adhesions, reducing sternotomy complications in cardiovascular reoperations.
authors.affiliation: Heart Institute of the Faculty of Medicine of the University of São Paulo, Márcio Cunha Hospital, São Francisco Xavier Foundation/USIMINAS. lrenatod@ig.com.br
authors.forename: Luiz Renato Dias
authors.initials: LR
authors.lastname: Daroz
authors.forename: Jackson Brandão
authors.initials: JB
authors.lastname: Lopes
authors.forename: Luis Alberto Oliveira
authors.initials: LA
authors.lastname: Dallan
authors.forename: Sérgio Paulo
authors.initials: SP
authors.lastname: Campana-Filho
authors.forename: Luiz Felipe Pinho
authors.initials: LF
authors.lastname: Moreira
authors.forename: Noedir Antônio Groppo
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry* / Q000494:pharmacology; D048271:Chitosan / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology; D003094:Collagen / Q000378:metabolism; D006331:Heart Diseases / Q000517:prevention & control*; D023421:Models, Animal; D010496:Pericardium / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D012086:Reoperation; D013242:Sterilization / Q000379:methods*; D013249:Sternum / Q000601:surgery; D013552:Swine; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
chemical_list: D001672:Biocompatible Materials; C514968:carboxymethyl-chitosan; D003094:Collagen; D048271:Chitosan