A new bioabsorbable polymer film to prevent peritoneal adhesions validated in a post-surgical animal model

Lucie Allègre,Stephanie Huberlant,Vincent Letouzey,Hubert Taillades,Isabelle Le Teuff,Salomé Leprince,Sophie Warembourg,Xavier Garric,Yogendra Kumar Mishra

doi:10.1371/journal.pone.0202285

Abstract

BackgroundPeritoneal adhesions are a serious surgical postoperative complication. The aim of this study is to investigate, in a rat model, the anti-adhesive effects of a bioabsorbable film of polymer combining polyethylene glycol and polylactic acid.Materials and methodsSixty-three animals were randomized into five groups according to the anti-adhesion treatment: Hyalobarrier®, Seprafilm®, Polymer A (PA), Polymer B (PB), and control. The rats were euthanized on days 5 and 12 to evaluate the extent, severity and degree of adhesions and histopathological changes. Three animals were euthanized at day 2 in PA, PB and control groups to observe the in vivo elimination.ResultsMacroscopic adhesion formation was significantly lower in the PA group than in the control group at day 5 (median adhesion score 0±0 vs 9.6 ±0.5 p = 0.002) and at day 12 (0±0 vs 7.3±4 p = 0.02). Furthermore, median adhesion score at day 5 was significantly lower in the PA group than in the Seprafilm group (0±0 vs 4.2± 3.9 p = 0.03). Residence time of PA seems longer than PB.ConclusionThe PA bioabsorbable film seems efficient in preventing the formation of peritoneal adhesions.

Highlights

Intraperitoneal adhesions are the most common complication of gynecological surgery, occurring in 50% to 100% of women [1]
Macroscopic adhesion formation was significantly lower in the Polymer A (PA) group than in the control group at day 5 and at day 12 (0±0 vs 7.3 ±4 p = 0.02)
Residence time of PA seems longer than Polymer B (PB)

Summary

Introduction

Intraperitoneal adhesions are the most common complication of gynecological surgery, occurring in 50% to 100% of women [1]. They are associated with considerable comorbidity including chronic pelvic pain, dyspareunia, subfertility and bowel obstruction [2]. Following a peritoneal trauma there is an increase in vessel permeability and an exudation of inflammatory cells. This phenomenon leads to the formation of a fibrin matrix between 5 and 7 days which is thereafter replaced by a fibrin band during the second week after surgery [7]. The aim of this study is to investigate, in a rat model, the anti-adhesive effects of a bioabsorbable film of polymer combining polyethylene glycol and polylactic acid

Objectives

Results

Conclusion