title: Prevention of peritendinous adhesions with electrospun chitosan-grafted polycaprolactone nanofibrous membranes.
abstract: As one of the common complications after tendon injury and subsequent surgery, peritendinous adhesions could be minimized by directly placing a physical barrier between the injured site and the surrounding tissue. With the aim of solving the shortcomings of current biodegradable anti-adhesion barrier membranes, we propose the use of an electrospun chitosan-grafted polycaprolactone (PCL-g-CS) nanofibrous membrane (NFM) to prevent peritendinous adhesions. After introducing carboxyl groups on the surface by oxygen plasma treatment, the polycaprolactone (PCL) NFM was covalently grafted with chitosan (CS) molecules, with carbodiimide as the coupling agent. Compared with PCL NFM, PCL-g-CS NFM showed a similar fiber diameter, permeation coefficient for bovine serum albumin, ultimate tensile strain, reduced pore diameter, lower water contact angle, increased water sorption and tensile strength. With its submicrometer pore diameter (0.6-0.9μm), both NFMs could allow the diffusion of nutrients and waste while blocking fibroblast penetration to prevent adhesion formation after tendon surgery. Cell culture experiments verified that PCL-g-CS NFM can reduce fibroblast attachment while maintaining the biocompatibility of PCL NFM, implicating a synergistic anti-adhesion effect to raise the anti-adhesion efficacy. In vivo studies with a rabbit flexor digitorum profundus tendon surgery model confirmed that PCL-g-CS NFM effectively reduced peritendinous adhesion from gross observation, histology, joint flexion angle, gliding excursion and biomechanical evaluation. An injured tendon wrapped with PCL-g-CS NFM showed the same tensile strength as the naturally healed tendon, indicating that the anti-adhesion NFM will not compromise tendon healing.
authors.affiliation: Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 333, Taiwan, ROC.
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Chen
authors.affiliation: Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 333, Taiwan, ROC; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Craniofacial Research Center, Chang Gung University, Kwei-San, Taoyuan 333, Taiwan, ROC.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 333, Taiwan, ROC.
authors.forename: Yi Teng
authors.initials: YT
authors.lastname: Fong
authors.affiliation: Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 333, Taiwan, ROC; Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kwei-San, Taoyuan 333, Taiwan, ROC. Electronic address: jpchen@mail.cgu.edu.tw.
authors.forename: Jyh-Ping
authors.initials: JP
authors.lastname: Chen
mesh_terms: D000818:Animals; D048271:Chitosan / Q000737:chemistry*; D004595:Electroplating / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D048091:Guided Tissue Regeneration / Q000295:instrumentation; D008422:Materials Testing; D008567:Membranes, Artificial; D057139:Nanofibers / Q000737:chemistry* / Q000648:ultrastructure; D010316:Particle Size; D011817:Rabbits; D012399:Rotation; D052256:Tendinopathy / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D013710:Tendons / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D013718:Tensile Strength; D000267:Tissue Adhesions / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control*; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D008567:Membranes, Artificial; D048271:Chitosan
keywords: Anti-adhesion; Chitosan; Nanofibrous membranes; Polycaprolactone; Surface grafting