Adhesion Prevention after Laminectomy Using Silk‐Polyethylene Glycol Hydrogels
Adhesion Prevention after Laminectomy Using Silk‐Polyethylene Glycol Hydrogels
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DOI：
10.1002/adhm.201500392
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发表时间：
2015-10
影响因子：
10
通讯作者：
Yansong Wang;Min Liang;Zhaozhu Zheng;Liangchen Shi;Bo Su;Jian Liu;D. Kaplan;Bin Zhang;Xiaoqin Wang
中科院分区：
文献类型：
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作者：
Yansong Wang;Min Liang;Zhaozhu Zheng;Liangchen Shi;Bo Su;Jian Liu;D. Kaplan;Bin Zhang;Xiaoqin Wang
椎板切除术是脊柱外科中的常见手术，以减少脊髓和神经压力。然而，疤痕组织经常在椎管内形成并粘附在硬膜表面，导致术后腰痛。在本研究中，评价了可生物降解的丝-聚乙二醇（PEG）水凝胶在新西兰兔椎板切除术后的粘连预防作用，并以不可降解的膨体聚四氟乙烯（ePTFE）膜和生理盐水作为对照。两周内三组间无显著性差异。蚕丝在6周内完全降解，留下一个将疤痕组织和硬脑膜分开的间隙。8周后，生理盐水对照组中形成严重的硬脑膜瘢痕粘连，而ePTFE膜和silk-PEG水凝胶样品中未观察到粘连或轻度粘连。将人真皮成纤维细胞（HS-865-SK细胞）在丝-PEG水凝胶浸提液中和凝胶表面上培养。与组织培养板（无丝）和超声处理的丝水凝胶（无PEG）的对照相比，在两种条件下成纤维细胞的增殖最初显著降低，但在120小时后恢复，表明水凝胶的表面性质和PEG的局部暂时释放解释了本研究中在体内观察到的粘连预防。
Laminectomy is a common operation in spine surgery to reduce spinal cord and nerve pressure. However, scar tissues often form in the spinal canal and adhere to the dura surface, resulting in low back pain postsurgery. In the present study, biodegradable silk‐polyethylene glycol (PEG) hydrogels are evaluated for adhesion prevention after laminectomies in New Zealand rabbits, with nondegradable expanded polytetrafluoroethylene (ePTFE) membranes and saline as controls. No significant difference among the three groups is observed within 2 weeks. Silk is fully degraded within 6 weeks, leaving a gap separating the scar tissue and the dura mater. Severe dural scar adhesion form in the saline control group after 8 weeks, while no or mild adhesion is observed in the ePTFE membrane and silk‐PEG hydrogel samples. Human dermal fibroblasts (HS‐865‐SK cells) are cultured in the silk‐PEG hydrogel extracts and on top of gel surfaces. Compared to the controls of tissue culture plate (no silk) and sonicated silk hydrogels (no PEG), the proliferation of fibroblasts in both conditions is significantly reduced initially but resumes after 120 h, suggesting the surface properties of the hydrogels and local, temporal release of PEG accounts for the adhesion prevention observed in vivo in this study.