Prevention of abdominal adhesion formation by thermosensitive PECE-hydrogel in a rat uterine horn model

In this work, we investigated the efficacy of PECE-hydrogel in preventing postsurgical peritoneal adhesions in the rat uterine horn model. Standardized surgical traumas were applied to the peritoneum of the abdominal wall and the uterine horns. PECE hydrogel was applied to the two wound surfaces. Animals were euthanized at different times after surgery, and the gross necropsy findings were documented. Adhesion formation was assessed according to adhesion extent and adhesion severity, and the hydrogel degradation and healing of peritoneal wounds were observed. The remesothelialization was dynamically observed by scanning electron microscope. The results showed that none of the animals in the hydrogel-treated group (n = 12) developed adhesion. In contrast, all untreated animals (n = 12) had adhesions that could only be separated by sharp dissection (p < 0.001). The hydrogel could adhere to the peritoneal wounds and gradually disappear from the wounds within 7-9 days and transformed into viscous fluid being completely absorbed within 12 days. The injured parietal and visceral peritoneum was remesothelialized in about 7 and 9 days, respectively. This work confirmed that PECE hydrogel holds promise as a novel absorbable biomaterial for the reduction of postoperative adhesions after laparotomy.