title: Remote efficacy for two different forms of hyaluronate-based adhesion barriers.
abstract: BACKGROUND
  Chemically modified sodium hyaluronate and carboxymethylcellulose (HA/CMC) membrane clinically reduces adhesion formation following surgery but was not designed for laparoscopic use. HA/CMC powder of identical chemical composition has been developed to allow for application laparoscopically. We compared the adhesion reduction efficacy of HA/CMC powder and film when applied directly to or remote from sites of surgical trauma. We also investigated the effect of the powder on wound healing.
  
  
  METHODS
  Two animal models of adhesion formation were used to evaluate efficacy: a rat peritoneal sidewall defect model and a rabbit cecal abrasion/sidewall defect model. The products were applied directly to the defect or the contralateral sidewall. Adhesions were examined seven days after surgery. In a separate study, the effect of the powder on healing was evaluated at 5, 7, and 28 days using a rat incisional wound strength model.
  
  
  RESULTS
  HA/CMC powder and film, when applied directly to the peritoneal defect, significantly reduced adhesions relative to the untreated control in both models. Remote applications of HA/CMC powder also reduced adhesions. In contrast, remote applications of HA/CMC film had no effect. HA/CMC powder did not significantly alter incisional wound strength at any of the timepoints tested.
  
  
  CONCLUSIONS
  In our preclinical models, HA/CMC powder had similar adhesion reduction efficacy to HA/CMC film when applied directly to sites of trauma. In addition, HA/CMC powder reduced adhesions remote from the application site. Importantly, HA/CMC powder did not impair incisional wound healing. On the basis of these results, future investigation of HA/CMC powder is warranted.
authors.affiliation: Biomaterials Science and Engineering, Genzyme Corporation, Framingham, Massachusetts 01701, USA. Keith.greenawalt@genzyme.com
authors.forename: Keith E
authors.initials: KE
authors.lastname: Greenawalt
authors.forename: M Jude
authors.initials: MJ
authors.lastname: Colt
authors.forename: Rubina L
authors.initials: RL
authors.lastname: Corazzini
authors.forename: Olga L
authors.initials: OL
authors.lastname: Syrkina
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Jozefiak
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000008:administration & dosage; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage*; D005260:Female; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008422:Materials Testing; D008567:Membranes, Artificial; D023421:Models, Animal; D011208:Powders; D011817:Rabbits; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000517:prevention & control*; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011208:Powders; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium