Abstract
The formation of postoperative adhesions poses a major complication in surgery, especially in the treatment of tendon, where adhesions can result in an alteration of the biomechanical and gliding properties, impeding a proper functioning of the tendon. Current treatments to prevent adhesions in the tendon are mainly based on the use of mechanical barriers which isolate the tendon and prevent fibrin deposition. Despite the positive results in preclinical models, these results have not been translated to clinics. Thus, in this study we propose a porcine peritoneum xenograft as an alternative antiadhesion barrier which integrates a basal membrane, since the presence of a basal membrane together with an epithelium or mesothelium layer prevents the formation of adhesions in vivo. First results have shown the suitability of the porcine peritoneum xenograft as an antiadhesion barrier due to its lower crosslinking ratio (p<0.05) and faster degradation by MMPs in vitro than a commercially available tendon product, which suggest a faster remodelling in vivo. On the other hand, the porcine peritoneum showed higher mechanical properties (p<0.01) and a lower coefficient of friction (p<0.01), characteristics that make the porcine peritoneum an appropriate material for tendon regeneration. Furthermore, the presence in the xenograft of a collagen type IV and laminin network after decellularisation was confirmed with immunohistochemistry, which poses the potential of the porcine peritoneum as antiadhesion device due to the presence of a basal membrane. Preliminary cell assessment experiments showed different morphology of adult dermal fibroblast (ADFs) on the different sides of the material (basal membrane and connective tissue) due to the differences in composition of both layers. Furthermore, the culture of ADFs during 7 days in media conditioned with the porcine peritoneum resulted in higher proliferation and metabolic activity (p<0.05) than those observed in the control and the media conditioned with the commercial product, suggesting the presence of growth factors in the porcine peritoneum which promote the growth of cells. Although positive results have been observed regarding the potential of porcine peritoneum as antiadhesion barrier for tendon regeneration, further studies which assess the influence of the basal membrane on cell behaviour and confirm the potential of the xenograft as antiadhesion barrier are being carried out.
