Anti-Adhesion Effect of Composite Film Materials Based on Glycoluril-Modified Sodium Carboxymethyl Cellulose

Bakibaev A.A., Tuguldurova V.P., Lyapunova M.V., Ivanov V.V., Kaidash O.A., Udut E.V., Bukterov M.V., Buyko E.E., Kasyanova A.S., Malkov V.S.

Key words: anti-adhesive agents; barrier films; composite materials; cytotoxicity of film materials; carbamide-containing heterocyclic compounds; glycoluril.

2021, volume 13, issue 1, page 35.

DOI: https://doi.org/10.17691/stm2021.13.1.04

Full text

html pdf

1757

1279

Abstract
References
How to cite

The aim of the study was to develop composite film materials derived from modified sodium carboxymethyl cellulose and to evaluate their anti-adhesive effects.

Materials and Methods. The modified film materials were obtained by dissolving sodium carboxymethyl cellulose (Na-CMC) in an aqueous solution of a modifier (glycoluril) with subsequent homogenization and drying in a vacuum drying oven at room temperature. Physicomechanical parameters of the obtained films were determined using the Instron 3369 universal electromechanical testing machine (Great Britain) equipped with a climatic chamber (300–523 K), improved video extensometer, and the MKC-25 micrometer (Russia). Cytotoxicity of glycoluril-modified film materials derived from Na-CMC was studied by incubating cell cultures of 3T3-L1 mouse fibroblasts directly with extracts from films under study using a colorimetric test. Their anti-adhesion effect was investigated on 40 female Wistar rats by modeling a flat adhesion by inducing abrasion of the cecum and suturing the deserosed surface of the abdominal wall anatomically opposite the abrasion area. The presence of adhesions was assessed on day 8 after the operation. Commercial membrane Seprafilm (USA) was used as a reference sample.

Results. It was found that extracts obtained from film materials derived from Na-CMC modified with glycoluril at a concentration of 0.01 and 0.05 wt. % had no cytotoxic effect on the cell culture of mouse fibroblasts 3T3-L1. Flat adhesions were not detected when using Seprafilm. When film materials under study were placed in the abdominal cavity between the injured areas, formation of flat adhesions was not observed or observed in one case out of ten.

Conclusion. The obtained films are promising for preventing adhesions as a barrier-type agent. Modifying Na-CMC with glycoluril made it possible to create films that prevent formation of flat adhesions, have improved physical and mechanical properties and no cytotoxic effect.

Stepanyan S.A., Apoyan V.T., Mesropyan R.N., Eiramdzhan Kh.T., Zanadvorov L.V., Petrosyan A.A., Egiazaryan G.G. The application of antiadhesive means in prevention of peritoneal commissures. Vestnik khirurgii im. I.I. Grekova 2012; 171(1): 45–49.
Tang J., Xiang Z., Bernards M.T., Chen S. Peritoneal adhesions: occurrence, prevention and experimental models. Acta Biomater 2020; 116: 84–104, https://doi.org/10.1016/j.actbio.2020.08.036.
Ahmad G., Mackie F.L., Iles D.A., O’Flynn H., Dias S., Metwally M., Watson A. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev 2014; 7: CD001298, https://doi.org/10.1002/14651858.cd001298.pub4.
Rodgers K.E., Verco S.J., DiZerega G.S. Effects of intraperitoneal 4% icodextrin solution on the healing of bowel anastomoses and laparotomy incisions in rabbits. Colorectal Dis 2003; 5(4): 324–330, https://doi.org/10.1046/j.1463-1318.2003.00447.x.
Koehler R.H., Begos D., Berger D., Carey S., LeBlanc K., Park A., Ramshaw B., Smoot R., Voeller G. Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases. JSLS 2003; 7(4): 335–340.
Wang K., Li X.L., Liu J., Sun X., Yang H., Gao X. Using cross-linked hyaluronic acid gel to prevent postoperative lumbar epidural space adhesion: in vitro and in vivo studies. Eur Spine J 2020; 29(1): 129–140, https://doi.org/10.1007/s00586-019-06193-w.
Zhang Y., Gao C., Li X., Xu C., Zhang Y., Sun Z., Liu Y., Gao J. Thermosensitive methyl cellulose-based injectable hydrogels for post-operation anti-adhesion. Carbohydr Polym 2014; 101: 171–178, https://doi.org/10.1016/j.carbpol.2013.09.001.
de la Portilla F., Ynfante I., Bejarano D., Conde J., Fernández A., Ma Ortega J., Carranza G. Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E: an experimental study in rats. Dis Colon Rectum 2004; 47(12): 2157–2161, https://doi.org/10.1007/s10350-004-0741-6.
Kayaoglu H.A., Ozkan N., Hazinedaroglu S.M., Ersoy O.F., Koseoglu R.D. An assessment of the effects of two types of bioresorbable barriers to prevent postoperative intra-abdominal adhesions in rats. Surg Today 2005; 35(11): 946–950, https://doi.org/10.1007/s00595-004-3050-8.
Zawaneh P.N., Putnam D. Materials in surgery: a review of biomaterials in postsurgical tissue adhesion and seroma prevention. Tissue Eng Part B Rev 2008; 14(4): 377–391, https://doi.org/10.1089/ten.teb.2008.0226.
Bang S., Ko Y.G., Kim W.I., Cho D., Park W.H., Kwon O.H. Preventing postoperative tissue adhesion using injectable carboxymethyl cellulose-pullulan hydrogels. Int J Biol Macromol 2017; 105(Pt 1): 886–893, https://doi.org/10.1016/j.ijbiomac.2017.07.103.
Ota K., Sato K., Ogasawara J., Takahashi T., Mizunuma H., Tanaka M. Safe and easy technique for the laparoscopic application of Seprafilm® in gynecologic surgery. Asian J Endosc Surg 2019; 12(2): 242–245, https://doi.org/10.1111/ases.12621.
Becker L.C., Bergfeld W.F., Belsito D.V., Klaassen C.D., Marks J.G. Jr., Shank R.C., Slaga T.J., Snyder P.W., Alan Andersen F. Final report of the safety assessment of allantoin and its related complexes. Int J Toxicol 2010; 29(3 Suppl): 84S–97S, https://doi.org/10.1177/1091581810362805.
Mashkovskiy M.D. Lekarstvennye sredstva [Medicines]. Moscow: Novaya volna; 2005.
Repetto G., del Peso A., Zurita J.L. Neutral red uptake assay for the estimation of cell viability/cytotoxicity. Nat Protoc 2008; 3(7): 1125–1131, https://doi.org/10.1038/nprot.2008.75.
Ayushinova N.I., Shurygina I.A., Grigoriev E.G., Shurygin M.G. Inducement of experimental abdominal adhesions (literature review). Acta Biomedica Scientifica (East Siberian Biomedical Journal) 2018; 3(6): 107–113, https://doi.org/10.29413/abs.2018-3.6.15.
Konovalova M.V. Poluchenie i issledovanie protivospaechnykh bar’ernykh materialov na osnove biopolimerov pektina i khitozana. Dis. … kand. biol. nauk [Obtaining and research of anti-adhesion barrier materials based on biopolymers of pectin and chitosan. PhD Thesis]. Moscow; 2017.
Beburishvili A.G., Vorob’ev A.A., Mikhin I.V., Akinchits A.N., Kremer P.B., Poroyskiy S.V., Gushul A.V. Modern anti-adhesion barrier agents in the prevention of recurrence of acute adhesive intestinal obstruction. Endoskopicheskaya khirurgiya 2009; 15(1): 170–171.
Soltany S. Postoperative peritoneal adhesion: an update on physiopathology and novel traditional herbal and modern medical therapeutics. Naunyn Schmiedebergs Arch Pharmacol 2020, https://doi.org/10.1007/s00210-020-01961-8.
Attard J.A.P., MacLean A.R. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg 2007; 50(4): 291–300.
Hu C., Tang F., Wu Q., Guo B., Long W.A., Ruan Y., Li L. Novel trilaminar polymeric antiadhesion membrane prevents postoperative pericardial adhesion. Ann Thorac Surg 2021; 111(1): 184–189, https://doi.org/10.1016/j.athoracsur.2020.03.011.

Bakibaev A.A., Tuguldurova V.P., Lyapunova M.V., Ivanov V.V., Kaidash O.A., Udut E.V., Bukterov M.V., Buyko E.E., Kasyanova A.S., Malkov V.S. Anti-Adhesion Effect of Composite Film Materials Based on Glycoluril-Modified Sodium Carboxymethyl Cellulose. Sovremennye tehnologii v medicine 2021; 13(1): 35, https://doi.org/10.17691/stm2021.13.1.04