Characterization of Anti-Adhesion Properties of Alginate/Polyethylene Oxide Film to Reduce Postsurgical Peritoneal Adhesions

Abstract

Postsurgical peritoneal adhesions lead to severe complications including chronic abdominal pain, female infertility, and small bowel obstruction. Adhesions can be minimized by introducing a physical barrier film between the tissues after surgery. We newly developed an anti-adhesive barrier film using alginate and polyethylene oxide (PEO). We determined the anti-adhesive properties of our alginate/PEO film through in vitro and in vivo studies. Alginate fibrous films were synthesized using electrospinning technique. PEO was added to alginate at 1:9 to minimize the repulsive forces within highly anionic alginate to make the fibrous film synthesis reproducible. The alginate/PEO film was then characterized for its morphology using atomic force microscopy (AFM) and Fourier transform infrared (FTIR) spectroscopy. For the in vitro study, NIH-3T3 cells were selected and cytotoxicity analysis was performed additionally. In the in vivo study, an intra-abdominal adhesion rat model was used. Sixty rats underwent laparotomy and cecal abrasion, and then, the alginate/PEO film was applied to the adhesion induction site. Peritoneal adhesion was assessed macroscopically and microscopically 2 weeks after surgery. In the in vitro study, alginate/PEO film exhibited enhanced anti-adhesive and cell repellent properties. In addition, the cytotoxicity analysis showed that the alginate/PEO film was non-toxic to mammalian cells. In the in vivo study, the alginate/PEO film showed significant adhesion reduction in both macroscopic and microscopic evaluations. The observed results suggest that the alginate/PEO film can be used as an effective physical barrier between tissues for reduced postsurgical peritoneal adhesions.