Dynamic Hydrogels for Prevention of Post‐Operative Peritoneal Adhesions

Abstract

AbstractPost‐operative adhesions are fibrous bands of scar tissue formed between internal tissues and organs causing clinical morbidity and their prevention represents a critical unmet need. Over 20 million Americans undergo invasive surgery each year and 95% of those patients develop post‐operative adhesions. More specifically, peritoneal adhesions forming as a result of abdominal surgery can result in severe complications such as chronic pain or adhesive small bowel obstruction requiring secondary adhesiolysis surgery. Additionally, adhesiolysis increases operation times during reoperative procedures and increases the risk of hemorrhage and organ injury upon reentry. This work reports the use of a dynamically crosslinked polymer‐nanoparticle (PNP) hydrogel adhesion barrier comprised of hydrophobically modified hydroxypropylmethylcellulose and biodegradable PEG‐PLA nanoparticles. These materials have desirable viscoelastic and flow properties, long‐term physical stability during storage, permit administration via spraying, enable local retention in the abdominal cavity for 2 weeks, and definitively reduce peritoneal adhesion formation. Using a rodent ischemic button model to generate peritoneal adhesions (n > 4), the PNP hydrogel significantly reduced peritoneal adhesion severity compared to commercial control products when assessed by a standardized 5‐point scale (3.18 ± 1.07 versus 1.35 ± 0.63; p = 0.0014). These results suggest that the PNP hydrogel adhesion barrier is a simple and effective solution for the prevention of peritoneal adhesions.