Prevention of postoperative adhesions by a novel honeycomb-patterned poly(lactide) film in a rat experimental model

Intraperitoneal adhesion is a serious problem concerning abdominal surgery. This study evaluated the performance of a honeycomb-patterned poly(lactide) (HCPLA) film as a physical barrier for preventing postoperative adhesion. HCPLA films were prepared using dioleoylphosphatidylethanolamine (DOPE) or a copolymer of dodecylacrylamide and omega-carboxyhexylacrylamide (CAP) as a surfactant (HCPLA-DOPE and HCPLA-CAP, respectively). In an in vivo adhesion prevention experiment, male Sprague-Dawley rats underwent standard cecum abrasion before midline laparotomy. We placed 2 cm x 2 cm HCPLA and flat films on the gliding interfaces; untreated rats formed the control group. After 1 week, adhesion was scored from 0 to 4. No significant difference was observed in the scores among groups, but macroscopic differences in adhesion prevention were observed. The adhesive strength of HCPLA-DOPE (18.1 +/- 1.2 g) to skinless chicken breast was significantly higher than that of the flat film (15.2 +/- 0.8 g, p < 0.05). Further, the adhesion score after 1 week for the HCPLA-DOPE group (1.6 +/- 0.2) was significantly lower than that for the control group (3.0 +/- 0.3, p < 0.05) but comparable to that for the Seprafilm group (1.4 +/- 0.3). These results demonstrated the potential of HCPLA-DOPE as a physical barrier for preventing postoperative adhesion.