Abstract
Intra-abdominal adhesions following surgery are a challenging problem in surgical practice. This study fabricated different thermoplastic polyurethane (TPU) nanofibers with different average diameters using the electrospinning method. The conditions were evaluated by scanning electron microscopy (SEM), atomic force microscope (AFM), and Fourier transform infrared spectrometer (FTIR) analysis. A static tensile test was applied using a strength testing device to assess the mechanical properties of the electrospun scaffolds. By changing the effective electrospinning parameters, the best quality of nanofibers could be achieved with the lowest bead numbers. The electrospun nanofibers were evaluated in vivo using a rat cecal abrasion model. The macroscopic evaluation and the microscopic study, including the degree of adhesion and inflammation, were investigated after three and five weeks. The resultant electrospun TPU nanofibers had diameters ranging from about 200 to 1000 nm. The diameters and morphology of the nanofibers were significantly affected by the concentration of polymer. Uniform TPU nanofibers without beads could be prepared by electrospinning through reasonable control of the process concentration. These nanofibers' biodegradability and antibacterial properties were investigated by weight loss measurement and microdilution methods, respectively. The purpose of this study was to provide electrospun nanofibers having biodegradability and antibacterial properties that prevent any adhesions or inflammation after pelvic and abdominal surgeries. The in vivo experiments revealed that electrospun TPU nanofibers reduced the degree of abdominal adhesions. The histopathological study confirmed only a small extent of inflammatory cell infiltration in the 8% and 10% TPU. Conclusively, nanofibers containing 8% TPU significantly decreased the incidence and severity of postsurgical adhesions, and it is expected to be used in clinical applications in the future.
Highlights
Surgical intra-abdominal adhesions are a common cause of postoperative complications, which is found in most cases of abdominal and gynecological surgeries [1]
The representative absorption amide peaks are detected due to stretching vibration of C=O in the amide bond at around 1700 cm-1, bending vibration of amide bond N-H at around 1500 cm-1, and C–N stretching vibration amide bond at around 1220 cm-1 [42]. These results show that changes in concentrations do not disrupt the chemical structure of the thermoplastic polyurethane (TPU)
The morphology observed from scanning electron microscopy (SEM) and atomic force microscope (AFM) confirmed that the nanofibers had a uniform structure and fine morphology in higher concentrations
Summary
Surgical intra-abdominal adhesions are a common cause of postoperative complications, which is found in most cases of abdominal and gynecological surgeries [1]. Abdominal and pelvic adhesions typically form pathological bonds between defect areas such as damaged peritoneal surfaces and other tissues that come in contact with the visceral peritoneum in the uterus, ovaries, uterine tubes, and intestines [2]. These adhesions remain one of the most challenging problems in surgical procedures, and despite many efforts in surgical techniques, there is still no reliable strategy to BioMed Research International manage them. The effects of adhesion formation are long-term complications such as chronic abdominal and pelvic pain, bowel obstruction, female infertility, and difficulty with future operations [3]. The best approach to reduce the severity of complications, limit morbidity, and decrease the economic cost is to prevent the formation of postoperative adhesions
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