title: Prevention of retrosternal adhesion by novel biocompatible glue derived from food additives.
abstract: BACKGROUND
  Postoperative retrosternal adhesion increases the risk of cardiac injury during cardiac reoperation. We created a novel biodegradable glue called "Lydex" that is derived from food additives. The purpose of this study is to evaluate this new biomaterial's biocompatibility and its preventive effect on retrosternal adhesion.
  
  
  METHODS
  We performed a median sternotomy and anterior pericardiectomy on Japanese white rabbits, and then closed the chest (control, group 1; n = 12), implanted an expanded polytetrafluoroethylene membrane (group 2; n = 12), or applied Lydex (group 3; n = 12) before closure. After 4 weeks, we evaluated macroscopic adhesion (each group; n = 6) and microscopic findings for fibrosis and macrophage infiltration (each group; n = 6).
  
  
  RESULTS
  In group 3, the retrosternal adhesion score was significantly lower than in group 1 (P = .0022). There was no significant difference between groups 2 and 3. The fibrotic area ratio was significantly lower in group 3 than in groups 1 and 2 (P < .001 vs group 1; P < .001 vs group 2). In group 3, the macrophage count was significantly lower than in group 2 (P < .001) and almost equal to that in group 1.
  
  
  CONCLUSIONS
  Our findings indicate that Lydex reduces retrosternal adhesion and attenuates the progression of fibrosis with excellent biocompatibility. Lydex is a next-generation substance for safer cardiac reoperation, with excellent capability for preventing adhesion, biocompatible and biodegradable properties, and lower potential for viral infections related to human plasma or other animal-derived products.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kamitani
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Masumoto
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kotani
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ikeda
authors.forename: Suong-Hyu
authors.initials: SH
authors.lastname: Hyon
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D003911:Dextrans / Q000494:pharmacology*; D005355:Fibrosis; D005503:Food Additives / Q000494:pharmacology*; D008264:Macrophages / Q000187:drug effects / Q000473:pathology; D008477:Mediastinal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D010492:Pericardiectomy / Q000009:adverse effects; D011107:Polylysine / Q000494:pharmacology*; D011817:Rabbits; D012086:Reoperation; D056346:Sternotomy / Q000009:adverse effects*; D013997:Time Factors; D000267:Tissue Adhesions; D014014:Tissue Adhesives / Q000494:pharmacology*
chemical_list: D001672:Biocompatible Materials; D003911:Dextrans; D005503:Food Additives; D014014:Tissue Adhesives; D011107:Polylysine
keywords: 32; 40.1; 40.3; ePTFE; expanded polytetrafluoroethylene