Post-operative adhesions, a common complication of surgery, cause pain, impair organ functionality, and often require additional surgical interventions. Control of inflammation, protection of injured tissue, and rapid tissue repair are critical for adhesion prevention. Adhesion barriers are biomaterials used to prevent adhesions by physical separation of opposing injured tissues. Current adhesion barriers have poor anti-inflammatory and tissue regenerative properties. Umbilical cord tissue (UT), a part of the placenta, is inherently soft, conforming, biocompatible, and biodegradable, with antimicrobial, anti-inflammatory, and antifibrotic properties, making it an attractive alternative to currently available adhesion barriers. While use of fresh tissue is preferable, availability and short storage time limit its clinical use. A viable cryopreserved UT (vCUT) "point of care" allograft has recently become available. vCUT retains the extracellular matrix, growth factors, and native viable cells with the added advantage of a long shelf life at -80 °C. In this study, vCUT's anti-adhesion property was evaluated in a rabbit abdominal adhesion model. The cecum was abraded on two opposing sides, and vCUT was sutured to the abdominal wall on the treatment side; whereas the contralateral side of the abdomen served as an internal untreated control. Gross and histological evaluation was performed at 7, 28, and 67 days post-surgery. No adhesions were detectable on the vCUT treated side at all time points. Histological scores for adhesion, inflammation, and fibrosis were lower on the vCUT treated side as compared to the control side. In conclusion, the data supports the use of vCUT as an adhesion barrier in surgical procedures.
Keywords: ANGPT1, angiopoietin-1; ANGPT2, angiopoietin-2; ASTM, American Society for Testing and Materials; Adhesiolysis; Ang, angiogenin; C, Celsius; CD, cluster of differentiation; CO2, carbon dioxide; Cryopreserved; DAB, 3,3′-Diaminobenzidine; DMEM, Dulbecco’s modified Eagle’s medium; DMSO, dimethyl sulfoxide; DPBS, Dulbecco’s phosphate-buffered saline; ECM, extracellular matrix; EGF, epidermal growth factor; EtHd-1, ethidium homodimer-1; FBS, fetal bovine serum; FDA, United States Food & Drug Administration; Fibrosis; H&E, hematoxylin and eosin; HGF, hepatocyte growth factor; HRP, horseradish peroxidase; IGFBP-1, insulin-like growth factor binding protein-1; IL-10, interleukin 10; IL-1RA, interleukin-1 receptor antagonist; IV, intravenous; IgG, immunoglobulin; Inflammation; MT, Masson’s trichrome; PBS, phosphate-buffered saline; PDGF-AA, platelet-derived growth factor AA; PDGF-BB, platelet-derived growth factor BB; PLGA, poly(lactic-co-glycolic acid); PLGF, placental growth factor; Placental; Post-surgical; SD, standard deviation; SDF-1α, stromal cell-derived factor 1 alpha; TIMP-1, tissue inhibitor of metalloproteinases-1; UT, umbilical cord tissue; VEGF-D, vascular endothelial growth factor-D; bFGF, basic fibroblast growth factor; cAM, calcein acetoxymethyl; cm, centimeter; iNOS, inducible nitric oxide synthase; mg/kg, milligram/kilogram; mm, millimeter; rpm, revolutions per minute; vCUT, viable cryopreserved umbilical tissue.