Interferon/poly (lactic-co-glycolic acid) and chitosan/poly (lactic-co-glycolic acid) composite membranes for prevention of epidural scar adhesion following laminectomy / 中国组织工程研究

ABSTRACT

BACKGROUND: Epidural resistance materials are an approach to prevent the epidural scar adhesion after laminectomy. A composite membrane of mechanical separation and fibroblast inhibition is promising to be widely studied.OBJECTIVE: To prepare the interferon (IFN)/poly (lactic-co-glycolic acid) (PLGA) and chitosan/PLGA composite membranes, and to observe their effects on preventing epidural scar adhesion after laminectomy in rabbits.METHODS: L2 laminectomy was performed in 120 rabbits, which were randomly and evenly divided into six groups. The control group received nothing on epidurals. In the autologous free fat group, the exposed dura was covered with subcutaneous fat. In the sodium hyaluronate group, 1 mL sodium hyaluronate was dripped onto the dura. In the PLGA, chitosan/PLGA, and IFN/PLGA groups, the exposed dura was covered with one of the three membranes at a sufficient size. The animals were sacrificed at 2, 4, 6, 8 weeks postoperatively. The scar formation and adhesion to the dura in L2 laminectomy sites were observed and scored by gross observation. At 4 weeks postoperatively, fibroblast ultrastructure was observed through the use of transmission electron microscope.RESULTS AND CONCLUSION: Widespread scars formed in the control group. The scars in the autologous free fat and PLGA groups were less compared with the control group, but there was no significant difference between these two groups. In the early stage, the scars in the sodium hyaluronate group were obviously less compared with the autologous free rat and PLGA groups, while in the later period, the difference between them was not significant, but the results from the sodium hyaluronate group were still better compared with the control group. The scars and slight adhesion to the dura were observed in the chitosan/PLGA and IFN/PLGA groups. The effect of preventing scar adhesion in these two groups was remarkably superior to that in the other groups, but there was no significant difference between these two composite membrane groups. At 4 weeks postoperatively, fibroblast morphology and function in the control, autologous free rat, and PLGA groups were better than those in the chitosan/PLGA and IFN/PLGA groups. Chitosan/PLGA and IFN/PLGA composite membranes are effective materials to prevent epidural scar adhesion after laminectomy.