Preparation and evaluation of chitosan-carboxymethylcellulose membrane for prevention of postoperative intestinal adhesion: An experimental study / 第二军医大学学报

ABSTRACT

Objective: To prepare and evaluate the effectiveness of chitosan-carboxymethylcellulose membrane in preventing postoperative intestinal adhesion. Methods: Chitosan-carboxymethylcellulose membrane was prepared with 11 ratio of chitosan and carboxymethylcellulose. Glutaraldehyde and ammonium aluminium sulfate were used for cross-linkage, glycerin for enhancing plasticity; and then the product was dried. The membrane was observed with scanning electron microscopy (SEM) and its tensile strength and breaking elongation were measured. Forty-eight SD rats with ileum injury were randomly divided into A, B and C groups (n=16). During operation, the injury in group A was treated with chitosan-carboxymethylcellulose membrane, in group B with chitosan membrane, and in group C without treatment (control group). The adhesion was observed on the 14th postoperative day. Results: The tensile strength of chitosan-carboxymethylcellulose membrane was 20 MPa and the breaking elongation was 65%. SEM showed that the morphology of the membrane had crossed fibroid structures and irregular pores. The severity of adhesion in group A and B was significantly lower than that in group C (P<0.01). Milder inflammatory changes and less fibrous proliferation were found in group A and B compared with those in group C. Epithelia rehabilitated better in group A than in group B, and the proliferation of fibroblast was not significant under electron microscope. In group C, epithelia rehabilitated slowly and fibroblasts excreted collagen actively. Conclusion: Chitosan-carboxymethylcellulose membrane is feasible for suturing during operation and is effective in reducing intestinal adhesion and it is superior to chitosan membrane.