Visceral Adhesions Research Articles

Cation-π Interaction-Enhanced Self-Healing Injectable Hydrogels for Gastric Perforation Repair.

Surgical operations are the preferred treatment for gastric perforation (GP) but incur postoperative complications such as gastrointestinal adhesions and bacterial infections, leading to inefficient wound healing and serious complications that may even threaten the life of the patient. Developing hydrogel dressings capable of adapting to the gastric environment (acid) and decreasing visceral adhesions and bacterial infections after GP treatment is crucial. In this article, we developed an injectable, self-healing hydrogel using cation-π interactions between protonated amines and aromatic rings under acidic conditions and explored it for GP repair. The hydrogels demonstrate exceptional self-healing capabilities under acidic conditions and can be effectively tailored for the gastric environment. In addition, the hydrogel demonstrated significant efficacy in preventing gastrointestinal adhesion, reducing inflammation, promoting angiogenesis, and effectively facilitating wound healing in a rat GP model. This novel hydrogel demonstrates adaptability to the gastric environment, rendering it highly promising for potential applications in gastric trauma healing.

Effect of Compressive Modulus of Porous PVA Hydrogel Coating on the Preventing Adhesion of Polypropylene Mesh.

PP mesh is a widely used prosthetic material in hernia repair. However, visceral adhesion is one of the worst complications of this operation. Hence, an anti-adhesive PP mesh is developed by coating porous polyvinyl alcohol (PVA) hydrogel on PP surface via freezing-thawing process method. The compressive modulus of porous PVA hydrogel coating is first regulated by the addition of porogen sodium bicarbonate (NaHCO3) at various quality ratios with PVA. As expected, the porous hydrogel coating displayed modulus more closely resembling that of native abdominal wall tissue. In vitro tests demonstrate the modified PP mesh show superior coating stability, excellent hemocompatibility, and good cytocompatibility. In vivo experiments illustrate that PP mesh coated by the PVA4 hydrogel that mimicked the modulus of native abdominal wall could prevent adhesion effectively. Based on this, the rapamycin (RPM) is loaded into the porous PVA4 hydrogel coating to further improve anti-adhesive property of PP mesh. The Hematoxylin and eosin (H&E) and Masson trichrome (MT) staining results verified that the resulting mesh could alleviate the inflammation response and reduce the deposition of collagen around the implantation zone. The biomimetic mechanical property and anti-adhesive property of modified PP mesh make it a valuable candidate for application in hernioplasty.

Asymmetric porous composite hydrogel patch for microenvironment-adapted repair of contaminated abdominal wall defects

Effective antibacterial property and long-term mechanical support are essential for the repair of complex abdominal wall defects associated with infection. However, clinically available repair materials often fail to meet these requirements, resulting in high surgical failure rate and complications. In this study, an asymmetric porous composite hydrogel patch (cCS/PVA@BAC) with antibacterial, anti-adhesion, pro-healing, and durable mechanical support properties is designed for the efficient repair of contaminated abdominal wall defects. By stepwise phase-conversion and soaking method, robust and stable polyvinyl alcohol hydrogel (PVAH) is integrated with the biocompatible multicomponent hydrogel made of chitosan and carboxymethyl chitosan (cCS), and benzalkonium chloride (BAC) is loaded to enhance the antibacterial property. The cCS layer of cCS/PVA@BAC has an extracellular matrix-like porous structure, which can promote fibroblasts adhesion and wound healing. In contrast, the PVAH layer on the other side with a smooth and dense structure, which can reduce fibroblasts adhesion and prevent visceral adhesion. In addition, the composite hydrogel patch has good anti-swelling and anti-deformation properties as well as stable mechanical strength, thus can withstand high intraperitoneal pressure in the wet internal microenvironment. The loaded BAC can efficiently kill bacteria and improve the local inflammatory microenvironment. With these advantages, cCS/PVA@BAC can significantly reduce inflammation, promote tissue remodeling, and accelerate the healing of contaminated abdominal wall defects in the rat model. These findings suggest a potential use of multifunctional hydrogel patch as an ideal material for effective repair of contaminated soft tissue defects.

Designing a bi-layer multifunctional hydrogel patch based on polyvinyl alcohol, quaternized chitosan and gallic acid for abdominal wall defect repair

In abdominal wall defect repair, surgical site infection (SSI) remains the primary cause of failure, while complications like visceral adhesions present significant challenges following patch implantation. We designed a Janus multifunctional hydrogel patch (JMP) with antibacterial, anti-inflammatory, and anti-adhesive properties. The patch comprises two distinct layers: a pro-healing layer and an anti-adhesion layer. The pro-healing layer was created by a simple mixture of polyvinyl alcohol (PVA), quaternized chitosan (QCS), and gallic acid (GA), crosslinked to form PVA/QCS/GA (PQG) hydrogels through GA's self-assembly effect and hydrogen bonding. Additionally, the PVA anti-adhesive layer was constructed using a drying-assisted salting method, providing a smooth and dense physical barrier to prevent visceral adhesion while offering essential mechanical support to the abdominal wall. The hydrogel patch demonstrates widely adjustable mechanical properties, exceptional biocompatibility, and potent antimicrobial properties, along with a sustained and stable release of antioxidants. In rat models of skin and abdominal wall defects, the JMP effectively promoted tissue healing by controlling infection, inhibiting inflammation, stimulating neovascularization, and successfully preventing the formation of visceral adhesions. These compelling results highlight the JMP's potential to improve the success rate of abdominal wall defect repair and reduce surgical complications.

An antibacterial biologic patch based on bacterial cellulose for repair of infected hernias

Infection-associated complications and repair failures and antibiotic resistance have emerged as a formidable challenge in hernia repair surgery. Consequently, the development of antibiotic-free antibacterial patches for hernia repair has become an exigent clinical necessity. Herein, a GBC/Gel/LL37 biological patch (biopatch) with exceptional antibacterial properties is fabricated by grafting 2-Methacryloyloxyethyl trimethylammonium chloride (METAC), a unique quaternary ammonium salt with vinyl, onto bacterial cellulose (GBC), followed by compounding with gelatin (Gel) and LL37. The GBC/Gel/LL37 biopatch exhibits stable swelling capacity, remarkable mechanical properties, flexibility, and favorable biocompatibility. The synergistic effect of METAC and LL37 confers upon the GBC/Gel/LL37 biopatch excellent antibacterial efficacy against Staphylococcus aureus and Escherichia coli, effectively eliminating invading bacteria without the aid of exogenous antibiotics in vivo while significantly reducing local acute inflammation caused by infection. Furthermore, the practical efficacy of the GBC/Gel/LL37 biopatch is evaluated in an infected ventral hernia model, revealing that the GBC/Gel/LL37 biopatch can prevent the formation of visceral adhesions, facilitate the repair of infected ventral hernia, and effectively mitigate chronic inflammation. The prepared antibacterial GBC/Gel/LL37 biopatch is very effective in dealing with the risk of infection in hernia repair surgery and offers potential clinical opportunities for other soft injuries, exhibiting considerable clinical application prospects.

3D printing/electrospinning of a bilayered composite patch with antibacterial and antiadhesive properties for repairing abdominal wall defects.

The application of patch methods for repairing abdominal wall wounds presents a variety of challenges, such as adhesion and limited mobility due to inadequate mechanical strength and nonabsorbable materials. Among these complications, postoperative visceral adhesion and wound infection are particularly serious. In this study, a bilayered composite patch with a gelatin methacryloyl (GelMA)/sodium alginate (SA)-vancomycin (Van)@polycaprolactone (PCL) (GelMA/SA-Van@PCL) antibacterial layer was prepared via coaxial 3D printing and a polycaprolactone (PCL)-silicon dioxide (SiO2) antiadhesive layer (PCL-SiO2) was prepared via electrospinning and electrostatic spray for hernia repair. The evaluation of the physicochemical properties revealed that the composite patch had outstanding tensile properties (16 N cm-1), excellent swelling (swelling rate of 243.81 ± 12.52%) and degradation (degradation rate of 53.14 ± 3.02%) properties. Furthermore, the composite patch containing the antibiotic Van exhibited good antibacterial and long-term drug release properties. Both in vivo and in vitro experiments indicated that the composite patch displayed outstanding biocompatibility and antiadhesive properties and could prevent postoperative infections. In summary, the bilayered composite patch can effectively prevent postoperative complications while promoting tissue growth and repair and holds significant application potential in hernia repair.

A Review of Advanced Abdominal Wall Hernia Patch Materials.

Tension-free abdominal wall hernia patch materials (AWHPMs) play an important role in the repair of abdominal wall defects (AWDs), which have a recurrence rate of <1%. Nevertheless, there are still significant challenges in the development of tailored, biomimetic, and extracellular matrix (ECM)-like AWHPMs that satisfy the clinical demands of abdominal wall repair (AWR) while effectively handling post-operative complications associated with abdominal hernias, such as intra-abdominal visceral adhesion and abnormal healing. This extensive review presents a comprehensive guide to the high-end fabrication and the precise selection of these advanced AWHPMs. The review begins by briefly introducing the structures, sources, and properties of AWHPMs, and critically evaluates the advantages and disadvantages of different types of AWHPMs for AWR applications. The review subsequently summarizes and elaborates upon state-of-the-art AWHPM fabrication methods and their key characteristics (e.g., mechanical, physicochemical, and biological properties in vitro/vivo). This review uses compelling examples to demonstrate that advanced AWHPMs with multiple functionalities (e.g., anti-deformation, anti-inflammation, anti-adhesion, pro-healing properties, etc.) can meet the fundamental clinical demands required to successfully repair AWDs. In particular, there have been several developments in the enhancement of biomimetic AWHPMs with multiple properties, and additional breakthroughs are expected in the near future.

Killing two birds with one stone: A therapeutic copper-loaded bio-patch promoted abdominal wall repair via VEGF pathway.

Hernia and life-threatening intestinal obstruction often result from abdominal wall injuries, and the regeneration of abdominal wall defects is limited due to the lack of biocompatible, antibacterial and angiogenic scaffolding materials for treating injured tissues. Taking inspiration from the facile preparation of dopamine polymerization and its surface modification technology, in this study, multi-therapeutic copper element was introduced into porcine small intestinal submucosa (SIS) bio-patches through polydopamine (PDA) deposition, in order to regenerate abdominal wall injury. In both in vitro antibacterial assays, cytocompatibility assays and in vivo abdominal wall repair experiments, the SIS/PDA/Cu bio-patches exhibited robust antibacterial efficiency (＞99%), excellent biocompatibility to cells (＞90%), and enhanced neovascularization and improved collagen maturity compared to other commercially available patches (3.0-fold higher than the PP mesh), due to their activation of VEGF pathway. These findings indicated the bio-patch was a promising application for preventing visceral adhesion, bacterial infection, and promoting soft tissue regeneration.

Efficacy of combined inactivated vaccines against Vibrio alginolyticus and Streptococcus agalactiae infections in Nile tilapia in Egypt

Vibrio alginolyticus and Streptococcus agalactiae are important bacterial pathogens that yielded high losses in Nile tilapia in Egypt. The present study aimed to check the protective efficacy of inactivated whole-cell bivalent vaccines against these pathogens using incomplete Freund’s adjuvant and Montanide™ IMS 1312 VG as adjuvants. The antibody titers have been determined at different weeks post-vaccination (WPV). Moreover, the protection levels against the challenged bacterial pathogens have also been examined in relation to the time-dependent protection at different WPV. The results revealed that serum antibodies were generated in all immunized fish at 1st WPV, peaked at 4th WPV, continued, and gradually decreased from 6th WPV to 14th WPV in all vaccinated groups. In addition, vaccines induced significantly higher protection of the immunized tilapia, manifested by higher survival rates. We noticed that the antibody levels and survival rates of the vaccinated fish by a vaccine adjuvanted by Montanide™ IMS 1312 VG were higher than those produced by a vaccine adjuvanted by incomplete Freund’s adjuvant at different time points. Moreover, no external clinical signs, visceral adhesions, or internal lesions were recorded in the vaccinated tilapia, demonstrating the safety of the formulated vaccines. According to the aforementioned findings, we could suggest that the prepared bivalent vaccines, using the two adjuvant types, are safe and highly protective and could be utilized as promising candidate vaccines to increase the resistance of Nile tilapia against V. alginolyticus and S. agalactiae infections. Moreover, Montanide™ IMS 1312 VG enhanced the immuno-protectivity and exhibited optimum immune response and earlier protection compared to the vaccine adjuvanted by incomplete Freund’s adjuvant, demonstrating its added value during the preparation of tilapia vaccines.

Biomimetic Janus Collagen Patch with Antideformation, Antiadhesion, and Prohealing Properties for Rehabilitation of Full‐Layer Uterine Injuries, Toward Efficient Live Births

AbstractUterine abnormalities infertility can be treated with implantable patches for tension‐free healing. However, the existing clinical patches are still limited in effective uterus recovery, resulting in low pregnancy and live birth rates. Herein, a novel engineered, and biocompatible Janus collagen patch (JCOP) is developed to achieve excellent uterine defect recovery and increase effective live births. The JCOP can highly match the structure, micromorphology, and mechanical properties of a natural uterus due to homologous‐like tissue homogeneity. JCOP's rough surface and loose‐extracellular‐matrix‐like porosity promote fibroblast adhesion and tissue regeneration, whereas its smooth surface reduces fibroblast adhesion and prevents visceral adhesions. Additionally, it exhibits exceptional resistance to swelling and deformation along with stable mechanical strength for long‐term preservation in the body and can withstand the highest uterine pressure in a humid interior environment attributed to its superior structural layout. Moreover, JCOP@bF, a functional JCOP linked to basic fibroblast growth factor (bFGF) via a specific collagen‐binding domain, significantly promotes repair of the injured uterus, restores the ability of the endometrium to accept embryos, and supports their development to a viable stage in a rat model of uterine damage. This study shows great promise for treating infertility caused by uterine damage.

Menstrual, fertility and psychological impacts after uterine compression sutures for postpartum hemorrhage: a prospective cohort study

BackgroundUterine compression suture is an important conservative surgical technique in managing atonic postpartum hemorrhage. In this study, we aim to evaluate the subsequent menstrual, fertility and psychological outcomes after uterine compression sutures.MethodsThis was a prospective cohort study between 2009 and 2022 conducted in a tertiary obstetric unit (6000 deliveries per year) in Hong Kong SAR. Women with primary postpartum hemorrhage successfully treated with uterine compression sutures were followed-up in postnatal clinic for two years after delivery. Data on menstrual pattern were collected during each visit. Psychological impact after uterine compression suture was assessed using a standardized questionnaire. Subsequent pregnancies were identified by territory-wide computer registry and telephone interviews. Women with postpartum hemorrhage treated with uterotonic agents only were chosen as controls.ResultsIn our cohort (n = 80), 87.9% of women had return of menses within six months after delivery. Regular monthly cycle was observed in 95.6% of women. Majority of women reported similar menstrual flow (75%), menstrual days (85.3%) and no change in dysmenorrhea status (88.2%) as compared before. Among eight (11.8%) women who reported hypomenorrhea after uterine compression sutures, two cases of Asherman’s syndrome were diagnosed. Among 23 subsequent pregnancies (16 livebirths), no significant differences in outcome were observed except more omental or bowel adhesions (37.5% vs. 8.8%, p = 0.007), recurrence of hemorrhage (68.8% vs. 7.5%, p < 0.001) and repeated compression sutures (12.5% vs. 0%, p = 0.024) were seen in women with previous compression sutures. Over half of the couple declined future fertility after uterine compression sutures with 38.2% of women recalled unpleasant memories and 22.1% reported life-long adverse impact especially tokophobia.ConclusionMajority of women with history of uterine compression sutures had similar menstruation and pregnancy outcomes as compared to those who did not have sutures. However, they had higher intrapartum risk of visceral adhesions, recurrence of hemorrhage and repeated compression sutures next pregnancy. Furthermore, couple could be more susceptible to negative emotional impact.

Quality of life after hiatal hernia repair with biosynthetic mesh PhasixTM

Abstract Hiatal hernias are one of the most common types of hernia, which are found in 55–60% patients over 50 years, but only 9% are symptomatic. In most cases hiatal hernia manifests with the signs of gastroesophageal reflux disease (GERD) and is managed with lifestyle changes and proton pump inhibitors. In some cases, surgical therapy is indicated. Usually, surgical repair includes cruroplasty and fundoplication; however, the recurrence rate is up to 42%. Mesh reinforcement helps to decrease recurrence rate, but may lead to a development of visceral adhesions, erosions, mesh migration or infection. To avoid these complications, a new completely resorbable mesh PhasixTM is offered in the market. The aim of the study was to evaluate the quality of life (QoL), complications, and patient satisfaction after large hiatal hernia repair with PhasixTM mesh at 1-year follow-up. All the patients were satisfied with the surgery. The median GERD Health Related QoL index was 6.5 points, which is significantly less than before surgery — 29.5 points (p = 0.04). There were no mesh related complications and no clinical data of recurrence. Hiatal hernia repair with slowly resorbable biosynthetic mesh PhasixTM has acceptable results in terms of GERD Health Related QoL, complications and patient satisfaction at one-year follow-up.

P-152 COMPARISON OF ENHANCED-VIEW TOTALLY EXTRAPERITONEAL (ETEP) AND TRANSABDOMINAL (TARM) MINIMAL ACCESS TECHNIQUES FOR RETROMUSCULAR PLACEMENT OF PROSTHESIS IN THE TREATMENT OF IRREDUCIBLE MIDLINE VENTRAL HERNIA

Abstract Aim Retromuscular or sublay meshplasty has been advocated to reinstate abdominal wall strength following ventral hernia repair while avoiding complications like visceral adhesions, fistula formation and mesh infection. We aim to compare two minimally invasive approaches of sublay hernioplasty for irreducible ventral midline hernia with respect to their efficacy and safety. Material &amp; Methods We performed a retrospective study of 73 patients operated for primary and recurrent irreducible ventral midline hernia by eTEP or TARM repair with sublay meshplasty. We compared the intraoperative and post-operative complications, post-operative pain score, subjective technical ease of procedure, patient satisfaction and recurrence after 3 months and 12 months of surgery. Results &amp; Conclusion There was no significant difference in the outcome of surgery and complications by the two techniques. However, there was a significant subjective technical ease in the TARM group (n=35) due to ergonomic port placement and adhesiolysis and reduction of hernia contents done under vision. The number of ports used and post-operative pain score were higher in the TARM group as compared to that of the eTEP group. 96% of the patients belonging to both groups were satisfied with their surgery after a year on telephonic follow-up. However, a multicentric study with a larger sample size would be required to establish the advantage of one technique over the other.

427.6: Transplant of the Abdominal Rectus Fascia in Rodents, First Report of the Microsurgical Procedure, and Initial Results

Introduction: After intestinal or multivisceral transplants, the proper management and closure of the abdominal wall becomes a challenge. The enterocutaneous fistulas, ostomies, skin scars secondary to multiple previous surgeries or frozen abdomen syndrome are some of the predisposing factors. Synthetic meshes usually produce complications associated with infections and fistulas when used in unfavorable environments, in addition to high costs. Some previous clinical studies have shown benefits applying wall reconstruction techniques including the variant of using a non-vascularized fascia of the abdominal rectus muscle, described by our team. The need to better understand immunological aspects of this procedure we have conceived the concept of performing a murine model. Methods: The procedures were approved by the internal review board and ethics committee for the care and use of laboratory animals (CICUAL UF 2021-016, #PICT 2016-3677). Technical aspects were done reproducing the technique for humans, details and pitfalls are described as part of the results. Engraftment observations were made on days 7, 11, and 30 post-transplantation for each animal strain. At day 30, each recipient was sacrificed, serum and tissue samples were obtained (from the sheath, and the adjacent muscle tissue). Histological studies of the graft were performed. Results: 6 transplants of the abdominal rectus fascia (TxARF) were performed. All donors were female Sprague Dawley rats, while the recipients were 3 Sprague Dawley (3 isogenic TxARF) and 3 Wistar females (allogeneic TxARF). The skin was separated, and the abdominal muscle wall was completely removed to then perform the dissection under a microscope (Fig. 1). TxARF was done utilizing a continuous suture kind Surget with 6-0 Prolene, after removing the ARF and muscle of the recipient (Fig. 2), the skin is closed over the fascia. Once the Tx was finish a strict clinical follow-up of each rat was carried out providing initial treatment with Tramadol and Ceftriaxone; 30th day survival was 100%, 2 recipients developed seromas on days 5 and 11, both isogenic ARF. The visual observation of the grafts showed absence of tissue stiffness and the presence of macroscopic neovascularization (Fig. 3) None of the grafts presented visceral adhesions at the end of the observation period. On histological inspection, the grafts showed, no presence of leukocytes or apoptosic cells, the adjacent native muscle tissue did not present particularities. Conclusion: This first report of the TxARF in rodents, proofs the feasibility of these experimental and translational model. Likewise, it shows similar results to the published in the clinical field, there was absence rejection and abdominal adhesions in the short term under a model without immunosuppression. Further studies will be done to evaluate the immunogenicity, the loss of strength and elasticity as well as the long term results of transplanting the ARF.

A staged reconstruction technique utilizing bioprosthetic mesh reinforcement in the repair of giant omphalocele

Reconstruction of complex anterior abdominal wall defects, such as giant omphaloceles, remains a reconstructive challenge for plastic and pediatric surgeons. Though several repair techniques have been described in the literature, no standardized method has been explicitly developed to treat pediatric patients. The utilization of intraabdominal tissue expanders to augment the abdominal domain has been reported as a potential repair technique. Despite its documented application, substantial controversy remains regarding tissue expander implementation due to its associated complications. We describe a staged reconstruction technique with acellular dermal matrix-assisted musculofascial reconstruction followed by delayed skin closure. Utilization of this bioprosthetic mesh in the reconstruction of anterior abdominal wall defects is well-described in the adult population. We applied the principle to a preschool-aged child with a giant omphalocele. This technique provides a medium to bolster the musculofascia, limit the formation of visceral adhesions, decrease the need for numerous procedures, and reduce the risk of infection or pulmonary compromise. This report denotes that a bioprosthetic mesh reinforcement technique may be utilized for functional reconstruction of large, complex abdominal wall malformations in the pediatric population. • What is currently known about this topic? • Giant omphalocele repair methods using tissue expansion have been described. However, these patients remain a reconstructive challenge due to high complication rates. • What new information is contained in this article? • Description of a staged reconstruction using bioprosthetic mesh musculofascial reconstruction with delayed skin closure to repair giant omphalocele in a preschool-aged child.

Do Visceral Adhesions Affect the Growth of Sockeye Salmon in the North Pacific Ocean and Bering Sea?

Do Visceral Adhesions Affect the Growth of Sockeye Salmon in the North Pacific Ocean and Bering Sea?

Designing Double-Layer Multimaterial Composite Patch Scaffold with Adhesion Resistance for Hernia Repair.

Hernia repair mesh is associated with a number of complications, including adhesions and limited mobility, due to insufficient mechanical strength and nonresorbability. Among them, visceral adhesions are one of the most serious complications of patch repair. In this study, a degradable patch with an antiadhesive layer is prepared for hernia repair by 3D printing and electrospinning techniques using polycaprolactone, polyvinyl alcohol, and soybean peptide (SP). The study into the physicochemical properties of the patch is found that it has adequate mechanical strength requirements (16 N cm-1 ) and large elongation at break, which are superior than commercial polypropylene patches. In vivo and in vitro experiments show that human umbilical vein endothelial cells proliferated well on composite patches, and showed excellent biocompatibility with the host and little adhesion through a rat abdominal wall defect model. In conclusion, the results of this study show that composite patch can effectively reduce the occurrence of adhesions, while the addition of SP in the patch further enhances its biocompatibility. It is believed that a regenerative biological patch with great potential in hernia repair provides a new strategy for the development of new biomimetic biodegradable patches.

Alginate-assistant nanofiber integrated with polypropylene hernia mesh for efficient anti-adhesion effects and enhanced tissue compatibility

Polypropylene (PP) mesh has been one of the most frequently selected materials for abdominal wall hernia (AWH) repair in the past decades. However, the repair effectiveness is often compromised by the high incidence of adverse events. Improvements are highly desirable to reduce unwanted visceral adhesion and increase tissue integration. Herein, we developed a PP-based composite mesh combined with alginate-assistant nanofiber membrane (NFM) by assembling a large-pore lightweight PP mesh, a NFM barrier consisting of poly (lactic-co-glycolic acid) (PLGA) and polycaprolactone (PCL), and an alginate hydrogel (AH). In vitro studies revealed that the resulting meshes had excellent structural stability, mechanical properties, and biocompatibility. The NFM barriers were firmly attached to the PP substrates, with AH effectively eliminating the delamination without unwanted damage to the nanofiber barrier. In vivo experiments showed that incorporating AH-assistant NFM into PP prostheses could prevent visceral adhesion in an effective manner and promote mesh integration into surrounding tissues from the abdominal wall. These results prove a novel facile and successful strategy to endow prosthetic meshes with superior anti-adhesion capability and tissue compatibility for repairing AWH.

Peritoneum-Inspired Janus Porous Hydrogel with Anti-Deformation, Anti-Adhesion, and Pro-Healing Characteristics for Abdominal Wall Defect Treatment.

Implantable meshes used in tension-free repair operations facilitate treatment of internal soft-tissue defects. However, clinical meshes fail to achieve anti-deformation, anti-adhesion, and pro-healing properties simultaneously, leading to undesirable surgery outcomes. Herein, inspired by the peritoneum, a novel biocompatible Janus porous poly(vinyl alcohol) hydrogel (JPVA hydrogel) is developed to achieve efficient repair of internal soft-tissue defects by a facile yet efficient strategy based on top-down solvent exchange. The densely porous and smooth bottom-surface of JPVA hydrogel minimizes adhesion of fibroblasts and does not trigger any visceral adhesion, and its loose extracellular-matrix-like porous and rough top-surface can significantly improve fibroblast adhesion and tissue growth, leading to superior abdominal wall defect treatment to commercially available PP and PCO meshes. With unique anti-swelling property (maximum swelling ratio: 6.4%), JPVA hydrogel has long-lasting anti-deformation performance and maintains high mechanical strength after immersion in phosphate-buffered saline (PBS) for 14 days, enabling tolerance to the maximum abdominal pressure in an internal wet environment. By integrating visceral anti-adhesion and defect pro-healing with anti-deformation, the JPVA hydrogel patch shows great prospects for efficient internal soft-tissue defect repair.

Efficacy of pectin-honey hydrogel and vitamin E in prevention of post-surgical intraperitoneal adhesions in rabbits

Abdominal as well as intra-visceral adhesions are considered to be one of the major postsurgical complications which is the results of inflammation, coagulation and fibrin depositions due to surgical injuries or irritations at the time of surgical intervention. In the present study, eighteen numbers of apparently healthy adult rabbits of either sex equally divided in to three groups were used to see the efficacy of Pectin-Honey Hydrogel and Olive oil-vitamin E preparation in prevention of induced intraperitoneal adhesions. Group A, Group B and Group C were treated with intraperitoneal application of normal saline, Pectin-Honey Hydrogel and Olive oil-vitamin E preparation respectively following induced peritonitis. Clinical parameters (0th 2nd, 4th, 6th, 8th and 10th days), biochemistry of peritoneal fluid (0th, 10th, 20th and 30th days) was carried out. The surgical wounds were reopened on 10th, 20th and 30th day for macroscopic assessment of adhesions. Clinical parameters found to be significantly elevated (P &lt; 0.05) on 2nd post-surgical; however, the changes were within the physiological limit. Peritoneal fluid biochemistry revealed significant higher total protein concentration in Group A followed by Group C &amp; B. A significantly lower catalase activity of peritoneal fluid was found in Group B post-surgically. Macroscopic peritoneal and visceral adhesion score was recorded highest in Group A and lowest in Group B. The present study revealed that Pectin-Honey Hydrogel and Olive oil-vitamin E preparation effectively prevent peritoneal adhesion in rabbits and promises its clinical use.