orabase and Fibrosis

We measured the effectiveness of inhibition of adhesion and fibrosis on patient outcomes after epididymectomy as a treatment for chronic epididymitis.. An initial cohort of 152 patients was treated conservatively for chronic epididymitis. Of these patients 43 did not respond to conservative treatment and following informed consent they were enrolled in the clinical trial. The patients were randomized into 2 groups so that 22 underwent epididymectomy with concurrent administration of the inhibitors of adhesion and fibrosis hyaluronic acid and carboxymethylcellulose (group 1), and 21 underwent epididymectomy only (group 2). Visual analog pain scores and patient satisfaction scores were obtained at postoperative weeks 4, 12 and 24.. There were no postoperative complications such as wound infection or hematoma in either group. One patient was lost to followup from group 1 and 2 were lost from group 2. At postoperative week 24, 12 patients (57.1%) from group 1 and 3 (15.8%) from group 2 were pain-free, 6 (28.6%) from group 1 and 6 (31.6%) from group 2 exhibited limited pain relief, 2 (9.5%) from group 1 and 7 (36.8%) from group 2 exhibited no pain relief, and 1 (4.8%) from group 1 and 3 (15.8%) from group 2 exhibited recurrence of pain after initial resolution at earlier followup intervals (p = 0.028).. Inhibition of adhesion and fibrosis after epididymectomy as a treatment for chronic epididymitis improves pain relief and patient satisfaction.

Topics: Carboxymethylcellulose Sodium; Chronic Disease; Combined Modality Therapy; Epididymis; Epididymitis; Fibrosis; Humans; Hyaluronic Acid; Male; Middle Aged; Prospective Studies; Single-Blind Method; Tissue Adhesions; Treatment Outcome

This study aimed to compare the anti-epidural fibrosis and anti-inflammation effects of hyaluronic acid (HA)-carboxymethylcellulose (CMC)-alginate hydrogel, pure HA, and normal saline using a lumbar laminectomized rat model.. Thirty lumbar laminectomized adult rats were randomly assigned to three groups. The control group received normal saline, the HCA group received HA-CMC-alginate gel, and the HA group received pure HA gel soaked over the dura of the laminectomized area before closing the surgical wound. All rats were housed for eight weeks, then epidural fibrosis (EF) was histologically graded. In addition, the fibroblast and inflammatory cell density were computerized for evaluation.. The mean fibroblast densities were 32.03 × 102 ± 488, 13.22 × 102 ± 200, and 14.52 × 102 ± 368 cell/mm2 in the control, HCA, and HA groups, respectively. The mean inflammatory cell density was 30.74 × 102 ± 459, 5.90 × 102 ± 129, and 11.08 × 102 ± 282 cell/mm2 in the control, HCA, and HA groups, respectively. The mean fibroblast and inflammatory cell densities in the HCA and HA groups were significantly lower than in the control group (P < 0.05). The HCA group had a significantly lower inflammatory cell density than the HA group (P < 0.05). The fibrous adherence grading of HCA and HA was significantly lower than the control (P < 0.05).. HA-CMC-alginate gel and HA hydrogels seem to have a better preventative effect on EF than no treatment (control). HA-CMCalginate can exhibit a better anti-inflammatory effect than HA. HA-CMC-alginate can be effective in reducing EF and inflammation after lumbar laminectomy.

Topics: Alginates; Animals; Carboxymethylcellulose Sodium; Fibrosis; Hyaluronic Acid; Hydrogels; Rats; Saline Solution

The purpose of the study was to evaluate the effect of a solid mixture of sodium hyaluronate and carboxymethylcellulose (S-HA/CMC) for the prevention of adhesions after iatrogenic mucosal injury in murine nasal cavities. We introduced iatrogenic adhesions into the bilateral nasal cavities of 20 male Sprague-Dawley rats. S-HA/CMC was applied to the left nasal cavity, while no packing was placed in the right nasal cavity as a control. At 1, 2, and 4 weeks post-procedure, we examined the number of adhesions, the ratio of the longest cross-sectional length of adhesion to septal cartilage length (RAC), and the degree of fibrosis. S-HA/CMC significantly reduced the number of adhesions when compared to the control group in total (p = 0.031), but not at each individual time point. The S-HA/CMC group showed significantly shorter RAC than the control group in total (p = 0.044), but not at each individual time point. The total fibrosis score was less severe in the S-HA/CMC group than in the control group (p < 0.001), with a significant difference between the two groups at the second week (p = 0.001). Therefore, in an animal model, S-HA/CMC can prevent post-injury mucosal adhesions suggesting a potential for clinical applications in endoscopic sinus surgery. Further clinical trials are needed to determine the safety and efficacy of S-HA/CMC as nasal packing after endoscopic sinus surgery.

Topics: Animals; Carboxymethylcellulose Sodium; Endoscopy; Fibrosis; Hyaluronic Acid; Models, Animal; Nasal Cavity; Nasal Mucosa; Rats, Sprague-Dawley; Tissue Adhesions; Viscosupplements

Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm(®)) in the prevention of postoperative intraperitoneal adhesions in rats.. One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm(®) group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation.. All antiadhesive film groups (Seprafilm(®), placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm(®) in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm(®) group, but only one-quarter in the low-dose Statofilm group.. The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm(®) in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application.

Topics: Animals; Atorvastatin; Biocompatible Materials; Carboxymethylcellulose Sodium; Fibrosis; Heptanoic Acids; Hyaluronic Acid; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Pyrroles; Random Allocation; Rats; Rats, Wistar; Tissue Adhesions

To investigate the inhibitory effect of solid hyaluronic acid-carboxymethyl cellulose film (hyaluronic acid film) on the formation of postoperative wound adhesion on rabbit eyes.. We first created a conjunctival flap under which hyaluronic acid film was inserted. Then, we performed trabeculectomy on other rabbit eyes with hyaluronic acid film applied under and above the scleral flaps. Expression of proliferative cell nuclear antigen and alpha-smooth muscle actin (alpha-SMA) were histologically and immunohistochemically examined.. Hyaluronic acid film significantly prevented adhesions after both kinds of surgery. Particularly, subconjunctival scar formation was significantly inhibited when the film was simply inserted under the wound. Furthermore, the adhesion around the scleral flap of trabeculectomy was less formed in eyes treated with hyaluronic acid film than in control eyes. Immunoreactivity to proliferative cell nuclear antigen almost disappeared after 28 days postoperatively in both treated and control groups. The alpha-SMA-positive cells appeared much less around the film-treated wound than the control eye.. The present results indicate that hyaluronic acid film can inhibit the formation of postoperative adhesion around the conjunctiva and sclera.. The results of this study indicate that this substance has potential benefits for improving ophthalmic surgery, such as filtering surgery for glaucoma.

Topics: Actins; Animals; Carboxymethylcellulose Sodium; Cell Count; Cicatrix; Conjunctiva; Fibrosis; Hyaluronic Acid; Immunoenzyme Techniques; Membranes, Artificial; Postoperative Complications; Proliferating Cell Nuclear Antigen; Rabbits; Sclera; Surgical Flaps; Trabeculectomy

The goal of nerve repair in the peripheral nervous system is to increase the number of axons passing from proximal to distal stump, and to enable the regenerated axons to reach the end organ as soon as possible. In the present study, the effect of the membrane formed by a mixture of hyaluronic acid and carboxymethylcellulose (HA-CMC) on nerve regeneration and perineurial scar formation was investigated. Eighteen New Zealand rabbits were allocated into control (n = 9) and experimental groups (n = 9). In the control group, conventional nerve repair was carried out following the transection of the sciatic nerve, while in the experimental group, following repair of the nerve, the repair line was covered by HA-CMC membrane extending 1 cm beyond the distal and proximal ends. Nerve regeneration and extraneurial adhesion formation were compared between the two groups 3 months later. It was observed that adhesion in the surrounding tissues was significantly less in the experimental group than in the control group. Furthermore, morphometric analysis of specimens obtained from the distal parts of nerves showed that the number of axons with myelin was higher in the experimental group than in the control group, with a statistically significant difference. Histologic sections obtained from the nerve repair line demonstrated that extraneural and intraneural fibrosis was significantly lower in the experimental group. It was concluded that HA-CMC membrane had a favorable effect on nerve regeneration, as well as extraneural scar formation, encouraging the clinical application of HA-CMC following nerve injuries.

Topics: Animals; Axons; Carboxymethylcellulose Sodium; Fibrosis; Hyaluronic Acid; Membranes, Artificial; Myelin Sheath; Nerve Regeneration; Rabbits; Sciatic Nerve; Tissue Adhesions; Wounds and Injuries

In 1980, Lim and Sun introduced a microcapsule coated with an alginate/polylysine complex for encapsulation of pancreatic islets. Characteristic to this type of capsule is, that it consists of a plain membrane which is formed during a single procedural step. With such a simple process it is difficult to obtain instantly a membrane optimized with respect to all the properties requested for islet transplantation. To overcome these difficulties, it is recommended to build up the membrane in several consecutive steps, each optimized for a certain property. In this study, we have analysed such a multilayer microcapsule for the encapsulation of pancreatic islets. Therefore, empty and islet containing alginate beads were coated with alternating layers of polyethyleneimine, polyacrylacid or carboxymethylcellulose and alginate. By scanning electron microscopy the thickness of the covering multilayer-membrane was estimated to be less than 800 nm by comparison with an apparatus scale. Ellipsometric measurements showed that the membrane thickness is in the range of 145 nm. Neither the encapsulation procedure, nor the membrane-forming step did impede the stimulatory response of the islets. The encapsulation even lead to a significantly better stimulatory response of the encapsulated islets during week three and five of cell culture. Furthermore, the multilayer-membrane did not deteriorate the biocompatibility of the transplanted microcapsules, allowing an easy tuning of the molecular cut-off and the mechanical stability depending on the polycation-polyanion combination used. The multilayer membrane capsule has obvious advantages compared to a one-step encapsulation procedure. These beads guarantee a high biocompatibility, a precisely adjusted cut-off, an optimal insulin-response and high mechanical stability although the membrane is only 145 nm thick.

Topics: Acrylic Resins; Alginates; Animals; Biocompatible Materials; Biopolymers; Carboxymethylcellulose Sodium; Cells, Cultured; Compressive Strength; Drug Compounding; Female; Fibrosis; Glucuronic Acid; Hexuronic Acids; Islets of Langerhans Transplantation; Materials Testing; Microspheres; Muscle, Skeletal; Particle Size; Permeability; Polyethyleneimine; Polyethylenes; Polylysine; Prostheses and Implants; Quaternary Ammonium Compounds; Rats; Rats, Inbred Lew; Rats, Sprague-Dawley; Transplantation, Heterotopic

To determine the prevention of adhesions interferes with the healing of jejunal anastomosis.. Twenty-five rats allocated into five groups.. Group 1- intraperitoneal injection of 12ml-1% sodium carboxymethylcellulose (SCMC). Groups 2-5- jejunal anastomosis. Groups 3 and 5- intraperitoneal SCMC-12 ml. The animals of the groups 2 and 4- only anastomosis. The rats of the groups 2 and 3- reopened on the 5th and those of groups 4 and 5 on the 21st postoperative days. Abdominal adhesions were graded and burst pressure of the anastomosis measured. Histological studies of anastomotic healing were performed.. Group 1 did not present any abnormality. Groups reopened on the 5th day did not differ in the burst pressures of the anastomosis and adhesion grades. The burst pressures in the groups reopened on the 21st postoperative day also did not differ. Histological patterns were similar in both groups on the 5th day, but on the 21st day, the rats treated with SCMC showed a maturer intestinal healing.. The prevention of adhesions not only did not interfere with jejunal anastomotic resistance, but also improved the intestinal healing in the rat.

Topics: Abdomen; Anastomosis, Surgical; Animals; Carboxymethylcellulose Sodium; Disease Susceptibility; Female; Fibrosis; Injections, Intraperitoneal; Jejunum; Male; Pressure; Rats; Rats, Wistar; Surgical Wound Dehiscence; Tissue Adhesions; Wound Healing

An experimental study on the effectiveness of various materials including poly carboxymethylcellulose (PCMC), gelatin foam (GF), ligment (L), free fat (FF) in prevention of peridural fibrosis and adhension (PDA) was done in 144 SD rats using a total laminectomy model (L1-2). PDA was measured with a double-blind protocol at 2, 4, 8, 12 weeks postoperatively by gross anatomical appearance (blunt-dissection), microscopical evaluation, computed imaging analysis and MRI enhanced with gadolinium. The results demonstrated that the peak of PDA is within 8 weeks after operation. PCMC, as a three dimensional protective material, could effectively inhibit PDFA after laminectomy, but GF and L could not. SHA had some effect in the early stage, but not in the late period. For FF though it could effectively prevent PDA, the incision infection rate was higher, the atrophy and necrosis of FF were serious. What is more, almost all transplanted fat remained in situ extended into the spinal cord in some measure after 8 weeks postoperatively.

Topics: Animals; Carboxymethylcellulose Sodium; Dura Mater; Female; Fibrosis; Laminectomy; Pharmaceutic Aids; Rats; Rats, Sprague-Dawley; Tissue Adhesions