Alginate film as a novel post-surgical tissue adhesion barrier

In this study, we focused on alginate as a physical tissue adhesion barrier material. The alginate has a muco-adhesive property in the solid state and becomes a viscous slippery gel-like solution in the dissolved state. We hypothesized that the alginate film without cross-linking can be a good candidate as a tissue adhesion barrier. The un-cross-linked alginate film may stably adhere onto a wound owing to its muco-adhesive property and, thus, does not need suturing to fix it, and then the film may slowly change into a slippery gel by hydration when in contact with body fluid and, thus, effectively separate the wound from the surrounding tissue without adhesion. To verify our hypothesis, we fabricated a un-cross-linked alginate film and its potential as a tissue adhesion barrier was evaluated through the comparison with various types of alginate (viscous solution and gel as well as cross-linked film) and a commercialized tissue adhesion barrier, Interceed, by the investigation of post-surgical peritoneal adhesion using a rat model. From the animal study, it was observed that the un-cross-linked alginate film was more effective for the prevention of peritoneal tissue adhesion than other types of alginates, including the commercialized one, probably owing to its unique muco-adhesive property (providing residence stability without suturing at the injured site) and lubricant property (by hydration in contact with body fluid) during wound healing. The un-cross-linked alginate film also showed a low inflammatory response and did not lead to specific histological influence during the wound healing. From these observations, the un-cross-linked alginate film is expected to be a simple and efficient tissue adhesion barrier applicable to various injury tissues.