The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 4 , Pages 801-806 , October 2010

Reduction in postsurgical adhesion formation after cardiac surgery by application of N,O-carboxymethyl chitosan

  • Juan Zhou, MD, PhD

      Affiliations

    • Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  • ,
  • J. Michael Lee, PhD

      Affiliations

    • Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • School of Biomedical Engineering, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  • ,
  • Patricia Jiang, BSc

      Affiliations

    • Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  • ,
  • Susan Henderson, BSc

      Affiliations

    • Kytogenics Pharmaceuticals Ltd, Dartmouth, Nova Scotia, Canada
  • ,
  • Timothy D.G. Lee, PhD

      Affiliations

    • Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    • Corresponding Author InformationAddress for reprints: Timothy D. G. Lee, PhD, Sir Charles Tupper Building, 5850 College Street, Dalhousie University, Halifax, NS, Canada, B3H 4H7.

Received 24 July 2009 ,Revised 17 October 2009 ,Accepted 14 November 2009.

References 

  1. Macmanus Q, Okies JE, Phillips SJ, Starr A. Surgical considerations in patients undergoing repeat median sternotomy. J Thorac Cardiovasc Surg. 1975;69:138–143
  2. Okuyama N, Wang CY, Rose EA, Rodgers KE, Pines E, diZerega GS, et al. Reduction of retrosternal and pericardial adhesions with rapidly resorbable polymer films. Ann Thorac Surg. 1999;68:913–918
  3. Tsukihara H, Takamoto S, Kitahori K, Matsuda K, Murakami A, Novick RJ, et al. Prevention of postoperative pericardial adhesions with a novel regenerative collagen sheet. Ann Thorac Surg. 2006;81:650–657
  4. Chorny M, Mishaly D, Leibowitz A, Domb AJ, Golomb G. Site-specific delivery of dexamethasone from biodegradable implants reduces formation of pericardial adhesions in rabbits. J Biomed Mater Res A. 2006;78:276–282
  5. Lu JH, Chang Y, Sung HW, Chiu YT, Yang PC, Hwang B. Heparinization on pericardial substitutes can reduce adhesion and epicardial inflammation in the dog. J Thorac Cardiovasc Surg. 1998;115:1111–1120
  6. Kennedy R, Costain DJ, McAlister VC, Lee TD. Prevention of experimental postoperative peritoneal adhesions by N, O-carboxymethyl chitosan. Surgery. 1996;120:866–870
  7. Costain DJ, Kennedy R, Ciona C, McAlister VC, Lee TD. Prevention of postsurgical adhesions with N, O-carboxymethyl chitosan: examination of the most efficacious preparation and the effect of N, O-carboxymethyl chitosan on postsurgical healing. Surgery. 1997;121:314–319
  8. Zhou J, Elson C, Lee TDG. Reduction in post surgical adhesion formation and re-formation after abdominal surgery using N, O-carboxymethyl Chitosan. Surgery. 2004;135:307–312
  9. Diamond MP, Luciano A, Johns DA, Dunn R, Young P, Bieber E. Reduction of postoperative adhesions by N, O-carboxymethylchitosan: a pilot study. Fertil Steril. 2003;631–636
  10. Zhou J, Liwski RS, Elson C, Lee TDG. Reduction in postsurgical adhesion formation after cardiac surgery in a rabbit model using N, O-carboxymethyl chitosan to block cell adherence. J Thorac Cardiovasc Surg. 2008;135:777–783
  11. Clark RAF. 2nd ed. Wound Repair, Overview and General Considerations. The Molecular and Cellular Biology of Wound Repair. New York: Plenum Press; 1996;
  12. Singer II, Scott S, Kawka DW, Kazazis DM, Gailit J, Ruoslahti E. Cell surface distribution of fibronectin and vitronectin receptors depends on substrate composition and extracellular matrix accumulation. J Cell Biol. 1988;106:2171–2182
  13. Ricketts SA, Sibbons PD, Green CJ. Quantitative analysis of the development of experimentally induced post surgical adhesions: a microstereological study. Int J Exp Pathol. 1999;80:325–334
  14. Harris ES, Morgan RF, Rodeheaver GT. Analysis of the kinetics of peritoneal adhesion formation in the rat and evaluation of potential antiadhesive agents. Surgery. 1995;117:663–669
  15. Miyamoto S, Katz BZ, Lafrenie RM, Yamada KM. Fibronectin and integrins in cell adhesion, signaling, and morphogenesis. Ann N Y Acad Sci. 1998;857:119–129
  16. Sommerfeldt DW, McLeod KJ, Rubin CT, Hadjiargyrou M. Differential phosphorylation of paxillin in response to surface-bound serum proteins during early osteoblast adhesion. Biochem Biophys Res Commun. 2001;285:355–363
  17. Johns DB, Rodgers KE, Donahue WD, Kiorpes TC, diZerega GS. Reduction of adhesion formation by postoperative administration of ionically cross-linked hyaluronic acid. Fertil Steril. 1997;68:37–42
  18. Rodgers KE, Johns DB, Girgis W, Campeau J, diZerega GS. Reduction of adhesion formation with hyaluronic acid after peritoneal surgery in rabbits. Fertil Steril. 1997;67:553–558

 This work was supported in full by Kytogenics Pharmaceuticals Ltd.

 Disclosures: S. Henderson is a shareholder in Kytogenics Pharmaceuticals Ltd. J. Zhou, M. Lee, P. Jiang, and T. Lee have no financial interest in Kytogenics Ltd.

PII: S0022-5223(09)01486-X

doi: 10.1016/j.jtcvs.2009.11.030

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 4 , Pages 801-806 , October 2010