Poly(glycerol sebacate) films prevent postoperative adhesions and allow laparoscopic placement.
BACKGROUND
The objectives of this study were to evaluate the efficacy of poly(glycerol) sebacate (PGS) films for the prevention of visceroparietal peritoneal (VP) adhesions and demonstrate the ease of laparoscopic PGS film placement. Peritoneal adhesions occur in nearly 95% of all abdominal operations. VP adhesions can cause serious postoperative complications. The interposition of a barrier between damaged peritoneal areas during re-epithelialization has been shown to prevent adhesion formation. Current barrier products have serious drawbacks, including poor degradability, variable efficacy, and difficult handling characteristics.


METHODS
The efficacy of PGS films to prevent VP adhesions was evaluated in a rat peritoneal adhesion model. The animals were evaluated for the presence of VP adhesions at 3, 5, and 8 weeks. The laparoscopic applicability of PGS films was demonstrated by placement into a juvenile porcine abdomen using standard laparoscopic equipment and techniques.


RESULTS
A statistically significant 94% reduction in VP adhesion formation rate was observed between control animals (75%) and animals with a PGS film barrier (4.8%). PGS films were easily placed in the juvenile porcine abdomen and could be readily repositioned without material loss or tissue damage.


CONCLUSIONS
PGS films possess a unique combination of properties, including biocompatibility, resorbability, and ease of handling. PGS barrier films were shown to be efficacious in reducing VP adhesions in the rat model. They also can be placed using standard laparoscopic techniques. These promising results suggest that PGS films will be effective barriers to adhesion formation for patients undergoing open and laparoscopic abdominal operations.
Pryor
Howard I
HI
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
O'Doherty
Elisabeth
E
Hart
Alison
A
Owens
Gwen
G
Hoganson
David
D
Vacanti
Joseph P
JP
Masiakos
Peter T
PT
Sundback
Cathryn A
CA
D000818:Animals; D001672:Biocompatible Materials / Q000008:administration & dosage; D003651:Decanoates / Q000008:administration & dosage; D005990:Glycerol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007415:Intestinal Obstruction / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008422:Materials Testing; D023421:Models, Animal; D010532:Peritoneal Diseases / Q000473:pathology / Q000517:prevention & control; D011108:Polymers / Q000008:administration & dosage; D051381:Rats; D017208:Rats, Wistar; D034421:Sus scrofa; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
D001672:Biocompatible Materials; D003651:Decanoates; D011108:Polymers; C469892:poly(glycerol-sebacate); D005990:Glycerol