TY - JOUR
T1 - Prevention of retrosternal adhesion formation in a rabbit model using bioresorbable films of polyethylene glycol and polylactic acid
AU - Okuyama, Naoki
AU - Rodgers, Kathleen E.
AU - Wang, Catherine Y.
AU - Girgis, Wefki
AU - Oz, Mehmet
AU - St. Amand, Karen
AU - Pines, Eli
AU - Decherney, Alexander H.
AU - Rose, Eric A.
AU - Cohn, Daniel
AU - Dizerega, Gere S.
PY - 1998/8
Y1 - 1998/8
N2 - The purpose of this study was to test the efficacy of three bioresorbable films of polyethylene glycol (EO) and polylactic acid (LA) (EO/LA = 1.5, 2.5, and 3.0) in the prevention of adhesion formation between the epicardium and the sternum (retrosternal adhesions) in a rabbit model. Retrosternal adhesions were generated by sternotomy, pericardiotomy, and abrasion of the anterior epicardium. The adhesion barrier was placed between the epicardium and the sternum and sutured to the edge of the pericardium. Epicardial adhesions were evaluated 14-20 days later by assessing the area of the epicardium covered by adhesions. In the control rabbits, tenacious adhesions were observed between sternum and the central portion of epicardium (portion exposed through the pericardiotomy) which were difficult to dissect. When a bioresorbable film was placed over the pericardium, adhesion formation at the central strip of the epicardium (area between the sternum and the epicardium exposed through the pericardium) could be reduced or prevented. At this site, the areas of adhesion formation were 0% (EO/L = 1.5), 8.4 ± 2.8% (EO/LA = 2.5), and 5.6 ± 4.7% (EO/LA = 3.0) of the central strip, significantly less than that observed in the control group, 78.0 ± 5.8% (P < 0.01). At the anterior left and right and posterior apex of the heart (sites where the film was not placed), there were no differences between control and treatment groups. The films were completely resorbed at the time of necropsy in group EO/LA = 2.5 and 3.0. Small pieces of film were observed in group EO/LA = 1.5. In conclusion, the bioresorbable films [EO/LA = 1.5 (REPEL-CV), 2.5, or 3.0] were efficacious in the reduction of retrosternal adhesions to the epicardium.
AB - The purpose of this study was to test the efficacy of three bioresorbable films of polyethylene glycol (EO) and polylactic acid (LA) (EO/LA = 1.5, 2.5, and 3.0) in the prevention of adhesion formation between the epicardium and the sternum (retrosternal adhesions) in a rabbit model. Retrosternal adhesions were generated by sternotomy, pericardiotomy, and abrasion of the anterior epicardium. The adhesion barrier was placed between the epicardium and the sternum and sutured to the edge of the pericardium. Epicardial adhesions were evaluated 14-20 days later by assessing the area of the epicardium covered by adhesions. In the control rabbits, tenacious adhesions were observed between sternum and the central portion of epicardium (portion exposed through the pericardiotomy) which were difficult to dissect. When a bioresorbable film was placed over the pericardium, adhesion formation at the central strip of the epicardium (area between the sternum and the epicardium exposed through the pericardium) could be reduced or prevented. At this site, the areas of adhesion formation were 0% (EO/L = 1.5), 8.4 ± 2.8% (EO/LA = 2.5), and 5.6 ± 4.7% (EO/LA = 3.0) of the central strip, significantly less than that observed in the control group, 78.0 ± 5.8% (P < 0.01). At the anterior left and right and posterior apex of the heart (sites where the film was not placed), there were no differences between control and treatment groups. The films were completely resorbed at the time of necropsy in group EO/LA = 2.5 and 3.0. Small pieces of film were observed in group EO/LA = 1.5. In conclusion, the bioresorbable films [EO/LA = 1.5 (REPEL-CV), 2.5, or 3.0] were efficacious in the reduction of retrosternal adhesions to the epicardium.
UR - http://www.scopus.com/inward/record.url?scp=0344936038&partnerID=8YFLogxK
U2 - 10.1006/jsre.1998.5317
DO - 10.1006/jsre.1998.5317
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C2 - 9733628
AN - SCOPUS:0344936038
SN - 0022-4804
VL - 78
SP - 118
EP - 122
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 2
ER -