Abstract
Abdominal wall defect caused by open abdomen (OA) or abdominal trauma is a serious issue since it induces several clinical problems. Although a variety of prosthetic materials are commonly employed, complications occur including host soft tissue response, fistula formation and chronic patient discomfort. Recently, abundant natural polymers have been used for injectable hydrogel synthesis in tissue regeneration. In this study, we produced the chitosan - hyaluronic acid (CS/HA) hydrogel and investigated its effects on abdominal tissue regeneration. The physical and biological properties of the hydrogel were demonstrated to be suitable for application in abdominal wounds. In a rat model simulating open abdomen and large abdominal wall defect, rapid cellular response, sufficient ECM deposition and marked neovascularization were found after the application of the hydrogel, compared to the control group and fibrin gel group. Further, the possible mechanism of these findings was studied. Cytokines involved in angiogenesis and cellular response were increased and the skew toward M2 macrophages credited with the functions of anti-inflammation and tissue repair was showed in CS/HA hydrogel group. These findings suggested that CS/HA hydrogel could prevent the complications and was promising for abdominal tissue regeneration.
Highlights
The abdominal cavity is commonly left open in a variety of situations potentially beneficial to patients with abdominal compartment syndrome (ACS) caused by infection or trauma[1,2,3]
The actual aldehyde content of A-hyaluronic acid (HA) was determined by hydroxylamine hydrochloride titration method, which revealed an extent of oxidation of 48.9%
open abdomen (OA) caused by ACS and abdominal wall tissue loss due to traumatic injury tissue loss contribute to abdominal wall defects, where spontaneous tissue regeneration cannot be achieved and abdominal viscera are exposed to air
Summary
The abdominal cavity is commonly left open in a variety of situations potentially beneficial to patients with abdominal compartment syndrome (ACS) caused by infection or trauma[1,2,3]. Synthetic non-biodegradable biomaterials such as polypropylene (PP) and polyethylene meshes are commonly used due to their excellent mechanical properties Because of their poor biocompatibility, placement of these materials alone may induce host soft tissue response, fistula formation and chronic patient discomfort[6,7,8]. Prolonged irradiation and the toxicity of the chemical crosslinking agents largely limit their applications Several polysaccharides such as dextran, chondroitin sulfate and hyaluronic acid (HA) were partially oxidized and reacted with amino to form injectable in situ hydrogels for possible medical applications such as cartilage tissue engineering[14] and adhesion prevention[15]. CS has been widely used in tissue engineering, wound healing, and other biomedical applications[19,20,21,22] because of its biological properties such as biocompatibility, biodegradability, nontoxicity, and good cell-bound capability.
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