Development of an anti-adhesive gelatin film-cut: A preliminary study of biological properties

Postoperative adhesions occur frequently after abdominal surgery and gynecological surgeries, causing serious complications. For applications in laparoscopic surgery, we developed a thermally cross-linked gelatin film-cut (GC) by dividing a thermally cross-linked gelatin film (GF) into small fragments. In this study, we examined the basic biological properties of the GC and conducted anti-adhesion tests using a rat cecum abrasion model to evaluate the effects of film fragmentation, focusing on the influence of fragment size, dosage and film thickness. Solubility test results showed that GC degraded more slowly than its film counterparts. Furthermore, as the thickness and the size of the GC increased, its degradation rate decreased. In addition, the results of the collagenase degradation test demonstrated that the GC degraded more slowly than the unfragmented film and that as the thickness and size of the GC increased, its degradation rate decreased. The results of the rat anti-adhesion test demonstrated that compared with GF, GC was significantly less effective in preventing adhesion. However, compared with the untreated group, several GCs showed significantly lower adhesion scores. Some of the GCs demonstrated anti-adhesion effect similar to or better than those of hyaluronic acid and carboxymethyl cellulose (HA/CMC). In summary, increased fragment size, reduced film thickness, and an elevated dosage of GC improved anti-adhesion efficacy. Thus, GC exhibits excellent anti-adhesion effects when its geometry, thickness, and dosage are optimized. Consequently, anti-adhesive GC improves the clinical applicability of anti-adhesion materials, particularly in laparoscopic surgery.