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Evaluation and characterization of waterborne biodegradable polyurethane films for the prevention of tendon postoperative adhesion

Authors Hsu SH, Dai L, Hung YM, Dai N

Received 1 April 2018

Accepted for publication 4 June 2018

Published 17 September 2018 Volume 2018:13 Pages 5485—5497

DOI https://doi.org/10.2147/IJN.S169825

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Dr Linlin Sun


Shan-hui Hsu,1 Lien-Guo Dai,2 Yu-Min Hung,1 Niann-Tzyy Dai3

1Institute of Polymer Science and Engineering, National Taiwan University, Taipei, Taiwan, Republic of China; 2Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China; 3Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China

Background:
Tendon adhesion is a serious problem and it affects tendon gliding and joint motion. Although recent studies have yielded promising results in developing anti-adhesion materials, there are still many problems. Polycaprolactone (PCL)-based polyurethane (PU) has good mechanical properties and biocompatibility, and it has a potential in anti-adhesion applications.
Materials and methods: In this study, a series of waterborne biodegradable polyurethane (WBPU) films with different ratios of ionic groups were synthesized. In order to select an effective anti-adhesion film, the WBPU films were cast and characterized for physicochemical properties and biocompatibility.
Results: All WBPU films were non-cytotoxic in the cell viability test and had suitable physicochemical and mechanical properties based on the measurement of zeta potential, water contact angle, mechanical properties, water absorption, thickness change, and gelatin test. To evaluate the anti-adhesion effect, severely injured tendons of rabbits were sutured with the modified Kessler core suture technique and WBPU films were then wrapped around the tendon. Implantation in rabbits showed that the WBPU film had better anti-adhesion effect than PCL films and the untreated control, and demonstrated no significant difference in the anti-adhesion performance from the commercial product Seprafilm based on gross evaluation, histological analysis, and biomechanical assessment.
Conclusion: Compared to Seprafilm and PCL applied in the tendon anti-adhesion, WBPU had better mechanical properties, low inflammatory reaction, and a proper degradation interval.

Keywords: adhesion, tendon, polyurethane, postoperative adhesion

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