Preventing postoperative tissue adhesion using injectable carboxymethyl cellulose-pullulan hydrogels.

Area of Science:

• Biomaterials Science
• Polymer Chemistry
• Regenerative Medicine

Background:

• Postoperative tissue adhesion is a common complication following surgical procedures.
• Current anti-adhesion strategies have limitations, necessitating novel solutions.
• Injectable hydrogels offer potential as minimally invasive therapeutic agents.

Purpose of the Study:

• To develop and evaluate an injectable adhesive hydrogel based on carboxymethyl cellulose (CMC) and pullulan as a postoperative anti-adhesion barrier.
• To investigate the properties and efficacy of the CMC-pullulan hydrogel in preventing tissue adhesion.

Main Methods:

• Carboxymethyl cellulose (CMC) was modified with tyramine for crosslinking via EDC-NHS reaction.
• An enzyme-mediated reaction using horseradish peroxidase (HRP) and hydrogen peroxide (H2O2) facilitated in situ hydrogel formation.
• Pullulan was incorporated to enhance adhesion and biodegradation.
• Characterization included ATR-FTIR, gelation time, storage modulus (G'), and weight loss measurements.
• In vitro cytotoxicity and in vivo animal tests were performed.

Main Results:

• The modified CMC was successfully synthesized and confirmed.
• Hydrogel properties, including gelation time and mechanical strength, were tunable by HRP and H2O2 concentrations.
• The hydrogel exhibited negligible cytotoxicity and supported cell proliferation.
• In vivo studies demonstrated a significant reduction in postoperative tissue adhesion using the CMC-pullulan hydrogel.

Conclusions:

• The developed CMC-pullulan hydrogel functions as an effective injectable in situ anti-adhesive agent.
• This hydrogel shows potential for clinical application in reducing postoperative adhesions.
• The study highlights the promise of enzyme-crosslinked CMC-based hydrogels in surgical interventions.