Development of a novel antiadhesive material, alginate flakes, ex vivo and in vivo

• Published in: Surgery today (Tokyo, Japan) Vol. 41; no. 7; pp. 970 - 977
• Main Authors: Hirasaki, Yoshinori, Fukunaga, Masaki, Kidokoro, Akio, Hashimoto, Ayumi, Nakamura, Tatsuo, Tsujimoto, Hiroyuki, Hagiwara, Akeo
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01-07-2011
• Subjects: Alginates - administration & dosage; Alginates - therapeutic use; Animals; Biocompatible Materials - administration & dosage; Biocompatible Materials - therapeutic use; Carboxymethylcellulose Sodium - administration & dosage; Carboxymethylcellulose Sodium - therapeutic use; Dermatologic Surgical Procedures; Female; Glucuronic Acid - administration & dosage; Glucuronic Acid - therapeutic use; Hexuronic Acids - administration & dosage; Hexuronic Acids - therapeutic use; Hyaluronic Acid - administration & dosage; Hyaluronic Acid - therapeutic use; Laparoscopy - adverse effects; Medicine; Medicine & Public Health; Models, Animal; Original Article; Postoperative Complications - prevention & control; Rats; Rats, Wistar; Surgery; Surgical Oncology; Swine; Laparoscopic surgery; Alginate; Antiadhesive material; Rat; Prevention of adhesion
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-010-4410-1

Purpose
Postoperative intra-abdominal adhesion sometimes causes significant morbidity. The aim of this study was to compare the efficacy of our newly developed antiadhesive material, alginate flakes, to the most commonly used combination of hyaluronic acid and carboxymethyl cellulose film.
Methods
Sodium alginate was formed into a gel, powder, or flakes. In the ex vivo study, these different alginate forms were attached onto pig skin and their antisolubility properties in saline and attachment stability were compared. In the in vivo study, a rat surgical adhesion model was used to study the properties of the alginates, and the rats were euthanized on day 14 after surgery. The efficacy of the antiadhesive materials was evaluated using an adhesion scoring system, and the locations that were treated with the antiadhesives were histologically examined.
Results
In the alginate groups, the alginate flakes were superior with respect to the antisolubility and the attachment stability ex vivo as well as with respect to the antiadhesive efficacy in vivo. The adhesion score was almost the same as that observed in the alginate flake and cellulose film groups.
Conclusions
We developed an alginate flake material and demonstrated its antiadhesive effects both ex vivo and in vivo. This is the first reported study using this flake-like material, which has a unique characteristic in that it can be applied by spraying in compressed air. Alginate flakes may therefore be especially useful in the field of laparoscopic surgery.