Properties And Prevention of Adhesions Applications of Bioelastic Materials

Abstract

AbstractThe origins, syntheses, variable composition and physical properties of bioelastic materials are discussed. The latter includes their capacity to undergo inverse temperature transitions to increased order on raising the temperature and to be designable to interconvert free energies involving the intensive variables of mechanical force, temperature, pressure, chemical potential, electrochemical potential and light.Bioelastic materials include analogues and other chemical variations of the viscoelastic polypeptide, poly(Val-Pro-Gly-Val-Gly), and cross-linked elastomeric matrices thereof. This parent material has been shown to be remarkably biocompatible; it can be minimally modified to vary the rate of hydrolytic breakdown; it can contain enzymatically reactive sites; and it can have cell attachment sites included which promote excellent cell adhesion, spreading and growth to confluence.One specific application is in the prevention of postoperative adhesion. There are some 30,000,000 per year surgical procedures in this country and a large portion of these would benefit if a suitable material were available for preventing adhesions. Bioelastic materials have been tested in a contaminated peritoneal model, and promising preliminary studies have been carried out in the rabbit eye model for strabismus surgery. In the peritoneal model, 90% of the 29 control animals exhibited significant adhesions; whereas, only 20% of the 29 animals using gas sterilized matrices had significant adhesions. On the basis of this data, it appears that cross-linked poly(VPGVG) is an effective physical barrier to adhesion formation in a trauma model with resulting hemorrhage and contamination.The potential use of bioelastic materials as a pericardial substitute following the more than 400,000 open heart surgeries per year in the U.S. is under development beginning with the use of bioelastic matrices to prevent adhesions to the total artificial heart being used as a bridge to heart transplantation such that the site will be less compromised when receiving the donor heart.