Abstract
In recent times, new anti-adhesion devices including devices based on carboxymethyl cellulose (CMC), which have “barrier” effect are being developed and actively introduced into surgical practice. The “barrier” should be completely resorbed after the time required to healing the morphofunctional integrity of the injured peritoneum, be economically available and easy to use (including laparoscopic technologies). But the time when the CMC is in the body is insufficient to prevent the formation of adhesions, particularly in the presence of non-absorbable rigid implants. The reactive functional groups in CMC allow to transform the CMC-macromolecule into a spatial structure. For this are required the using of bifunctional (bicarboxylic or aminocarboxylic) acids and the transform of a part of the carboxyl groups from the Na-form to the hardly soluble H-form, i.e., it is necessary to crosslink CMC-macromolecules. Adipic acid and glutaric acid, aminoacetic acid and amino capronic acid used are linking agents. The influence of modification parameters on the degree of polymers swelling in water is studied. As a result, to obtain membranes designed for the treatment of adhesive disease, it is recommended to use additives in CMC of bifunctional compounds.
Highlights
New anti-adhesion devices including devices based on carboxymethyl cellulose (CMC), which have “barrier” effect are being developed and actively introduced into surgical practice
The time when the CMC is in the body is insufficient to prevent the formation of adhesions, in the presence of non-absorbable rigid implants
The reactive functional groups in CMC allow to transform the CMC-macromolecule into a spatial structure. For this are required the using of bifunctional acids and the transform of a part of the carboxyl groups from the Na-form to the hardly soluble H-form, i.e., it is necessary to crosslink CMC-macromolecules
Summary
«Барьер» должен полностью рассасываться по истечении срока, необходимого для восстановления морфофункциональной целостности поврежденной брюшины, быть экономически доступным и простым в применении (включая лапароскопические технологии). Но время пребывания КМЦ в организме недостаточно для профилактики образования спаек, в частности в присутствии нерассасывающихся ригидных имплантатов. Наличие в карбоксиметилцеллюлозе реакционноспособных функциональных групп позволяет преобразовывать макромолекулы КМЦ в пространственную структуру. Для этого требуется использование бифункциональных (бикарбоновых или аминокарбоновых) кислот, а также перевод части карбоксильных групп из Na-формы в труднорастворимую Н-форму, т. С этой целью в качестве сшивающих агентов были использованы адипиновая и глутаровая, аминоуксусная и аминокапроновая кислоты. Для получения мембран, предназначенных для лечения спаечной болезни, рекомендовано применять добавки в КМЦ бифункциональных соединений. Ключевые слова: антиадгезивный барьер, карбоксиметилцеллюлоза, адипиновая, аминокапроновая, глутаровая, аминоуксусная кислота
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