Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan

The aim of this study is to evaluate CMC physical-chemical alterations after thermal sterilization and its efficacy in preventing poststernotomy pericardial adhesions.

After autoclaving thermal sterilization, thermal sterile Carboxymethyl Chitosan (CMCts) was submitted to physical-chemical analysis. Twelve animals were divided into two groups and underwent pericardiotomy and adhesion induction protocol. Afterward, topic CMCts or saline solution was administered. After 8 weeks, a sternotomy was performed for adhesion score macroscopic evaluation, dissection time and the amount of recalcitrant dissection, and microscopic evaluation.

Physical-chemical analysis showed no difference between CMC and CMCts. A macroscopic analysis showed that the intensity of adhesions was significantly lower in the CMCts group (P=0.007). Dissection time and use of recalcitrant dissection also decreased significantly (P=0.007, P=0.008; respectively). Microscopic results indicated a significant reduction in the epicardium collagen area and in the total epicardium area (P=0.05) and (P=0.03).

The sterilization method did not change Carboxymethyl Chitosan physical-chemical properties. Using barrier biopolymer, such as CMCts, can decrease the intensity of pericardium postoperative adhesions, reducing sternotomy complications in cardiovascular reoperations.