Adhesion prevention with ancrod released via a tissue-adherent hydrogel

Area of Science:

• Biomaterials Science
• Pharmacology
• Surgical Innovation

Background:

• Postoperative adhesions are a significant complication following gynecological surgery.
• Current prevention strategies have limitations in efficacy and delivery methods.

Purpose of the Study:

• To evaluate the efficacy of ancrod, a fibrinogenolytic protease, delivered via a photopolymerized biodegradable hydrogel for preventing postoperative adhesions.
• To compare local hydrogel delivery with systemic and intraperitoneal administration routes.

Main Methods:

• Ancrod was administered intravenously, intraperitoneally, and locally via a hydrogel in a rat uterine horn adhesion model.
• Adhesions were evaluated 7 days post-injury.
• Hydrogel precursor solution was photopolymerized in situ to form a tissue-adherent barrier.

Main Results:

• Local hydrogel delivery of ancrod reduced adhesions by 82%, significantly more than hydrogel alone (68%) or postoperative intraperitoneal injection (19%).
• Systemic intravenous administration reduced adhesions by 63% without dose sensitivity.
• Postoperative intraperitoneal administration showed dose-dependent efficacy, reducing adhesions by up to 84%.

Conclusions:

• Local delivery of ancrod from a tissue-adherent hydrogel is a highly efficacious strategy for preventing postoperative adhesions.
• This localized approach allows for effective prevention using a lower total dose of the protease.
• Biodegradable hydrogels offer a promising platform for targeted drug delivery in adhesion prevention.