A novel bioabsorbable pericardial membrane substitute to reduce postoperative pericardial adhesions in a XXXX model.

@entity1 @entity32 @entity8 @entity1989 @entity95 @entity7049 @entity730
OBJECTIVES: In paediatric cardiac surgery, reoperations remain challenging since the injury and the formation of dense adhesions before reoperations can be life-threatening to the heart, bypass conduits or great vessels. To prevent the formation of dense adhesions, a variety of different types of pericardial membrane substitute have been employed. However, due to peel formation, @entity730 and infection, the routine application of these pericardial membrane substitute has not been achieved clinically. A novel bioabsorbable membrane has been developed from @entity7049 ( @entity1989 ) to overcome these drawbacks. The purpose of this study was to assess the biosafety and the effectiveness of @entity1989 membrane as a new bioabsorbable pericardial membrane substitute after pericardium replacement in a @entity95 model. METHODS: A total of 33 @entity95 underwent abrasion on the surface of the heart through right thoracotomy and were divided into a @entity1989 membrane group (n = 17) and a control group (n = 16). Biosafety was assessed by comparing pre- and postoperative @entity8 and C-reactive protein levels. Subsequently, at 4 and 12 weeks postoperatively, the degree of reabsorption of the membrane and the intensity of adhesions were macroscopically assessed, followed by a microscopic evaluation for histological changes. Samples of the regenerated fibrous membranes that were harvested 12 weeks after implantation were used to perform immunostaining for cytokeratin and @entity1 bone marrow endothelial cell-1 (HBME-1). RESULTS: The @entity1989 membrane group exhibited a little inflammatory response (P > 0.05) and @entity8 (P > 0.05). The @entity1989 membrane was mostly absorbed by 12 weeks with the replacement of loosely adherent tissue. Moderate adhesions were found between the pericardial membrane substitute and the epicardium at the 4-week postoperative inspection. After 12 weeks postoperatively, the adhesions were found to have resolved completely. The composite score, which combined the histological findings of @entity32 and the tightness of adhesions, was graded on a scale of 0 to 3. Significant differences between the @entity1989 and control groups were detected at 4 weeks (1.2    0.4, 2.1    0.6; P = 0.007, respectively) and 12 weeks (0.5    0.5, 2.5    0.7; P = 0.001, respectively). Twelve weeks after the replacement of the pericardium with the @entity1989 membrane, as shown by the cells positively immunostained for cytokeratin and HBME-1, the regenerated membrane consisted of a bilayer structure mimicking the native pericardium. CONCLUSIONS: To prevent the formation of adhesions after cardiac surgery, the bioabsorbable @entity1989 membrane might serve as a promising substitute for the pericardium, which proved to be safe and efficacious in our study.
