期刊
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
卷 117, 期 50, 页码 32046-32055出版社
NATL ACAD SCIENCES
DOI: 10.1073/pnas.2012491117
关键词
zwitterionic polymer; postoperative adhesion; antiadhesion; adhesiolysis; hepatectomy
资金
- Wayne State University
- NSF [1410853, 1809229]
- National Institute of Diabetes and Digestive and Kidney Diseases of the NIH [DP2DK111910, R01DK123293]
- Direct For Mathematical & Physical Scien
- Division Of Materials Research [1410853] Funding Source: National Science Foundation
- Division Of Materials Research
- Direct For Mathematical & Physical Scien [1809229] Funding Source: National Science Foundation
Postoperative adhesions are most common issues for almost any types of abdominal and pelvic surgery, leading to adverse consequences. Pharmacological treatments and physical barrier devices are two main approaches to address postoperative adhesions but can only alleviate or reduce adhesions to some extent. There is an urgent need for a reliable approach to completely prevent post-operative adhesions and to significantly improve the clinical outcomes, which, however, is unmet with current technologies. Here we report that by applying a viscous, cream-like yet injectable zwitterionic polymer solution to the traumatized surface, postoperative adhesion was completely and reliably prevented in three clinically relevant but increasingly challenging models in rats. The success rate of full prevention is over 93% among 42 animals tested, which is a major leap in antiadhesion performance. Clinically used Interceed film can hardly prevent the adhesion in any of these models. Unlike current antiadhesion materials serving solely as physical barriers, the nonfouling zwitterionic polymer functioned as a protective layer for antiadhesion applications with the inherent benefit of resisting protein/cell adhesions. The nonfouling nature of the polymer prevented the absorption of fibronectins and fibroblasts, which contribute to the initial and late-stage development of the adhesion, respectively. This is the key working mechanism that differentiated our complete prevention approach from current underperforming antiadhesion materials. This work implies a safe, effective, and convenient way to fully prevent post-operative adhesions suffered by current surgical patients.
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