1. Prevention of postoperative pericardial adhesions using thermal sterile carboxymethyl chitosan.
- Author
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Daroz LR, Lopes JB, Dallan LA, Campana-Filho SP, Moreira LF, and Stolf NA
- Subjects
- Animals, Biocompatible Materials pharmacology, Chitosan chemistry, Chitosan pharmacology, Collagen metabolism, Models, Animal, Pericardium metabolism, Pericardium pathology, Random Allocation, Reoperation, Sternum surgery, Swine, Tissue Adhesions pathology, Tissue Adhesions prevention & control, Biocompatible Materials chemistry, Chitosan analogs & derivatives, Heart Diseases prevention & control, Pericardium surgery, Postoperative Complications prevention & control, Sterilization methods
- Abstract
Objective: The aim of this study is to evaluate CMC physical-chemical alterations after thermal sterilization and its efficacy in preventing poststernotomy pericardial adhesions., Methods: After autoclaving thermal sterilization, thermal sterile Carboxymethyl Chitosan (CMCts) was submitted to physical-chemical analysis. Twelve animals were divided into two groups and underwent pericardiotomy and adhesion induction protocol. Afterward, topic CMCts or saline solution was administered. After 8 weeks, a sternotomy was performed for adhesion score macroscopic evaluation, dissection time and the amount of recalcitrant dissection, and microscopic evaluation., Results: Physical-chemical analysis showed no difference between CMC and CMCts. A macroscopic analysis showed that the intensity of adhesions was significantly lower in the CMCts group (P=0.007). Dissection time and use of recalcitrant dissection also decreased significantly (P=0.007, P=0.008; respectively). Microscopic results indicated a significant reduction in the epicardium collagen area and in the total epicardium area (P=0.05) and (P=0.03)., Conclusion: The sterilization method did not change Carboxymethyl Chitosan physical-chemical properties. Using barrier biopolymer, such as CMCts, can decrease the intensity of pericardium postoperative adhesions, reducing sternotomy complications in cardiovascular reoperations.
- Published
- 2008
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