Viable Cryopreserved Umbilical Tissue (vcut) Barrier Reduces Post Operative Adhesions In A Rabbit Abdominal Adhesion Model
Sandeep Dhall1, Turhan Coksaygan2, Tyler M. Hoffman1, Mathew Moorman1, Anne Lerch1, Jin-Qiang Kuang1, Malathi Sathyamoorthy1, Alla Danilkovitch1.
1Osiris Therapeutics Inc., Columbia, MD, USA, 2University of Maryland, Baltimore, Baltimore, MD, USA.
Background: Postoperative adhesions are common complications in a wide range of surgeries, including abdominal, cardiothoracic and orthopedic procedures. Adhesions, caused by fibrosis, lead to pain and impaired organ function, and often require additional interventions. Fresh placental tissue has been reported to exhibit anti-fibrotic and anti-inflammatory properties, however tissue preservation methods have been shown to alter placental components and negatively impact tissue properties. Recently viable cryopreserved umbilical tissue (vCUT) allograft, with all tissue components preserved in their native state, became available for clinical use. We hypothesized that the application of vCUT would prevent the development of postoperative adhesions. Methods: To test our hypothesis we used a rabbit abdominal adhesion model. Cecum surface adjacent to sidewall defect and facing the rest of bowel was abraded with a sterile gauze for 15minutes and 5minutes respectively until petechial hemorrhage was observed. A 3x3cm2 of peritoneum and abdominal transverse muscle was removed on the lateral abdominal wall. vCUT was sutured to abdominal wall in test animals, followed by the bowel replaced into the abdomen and closure of cavity in all animals. Days 7, 28 and 74 post-surgery animals were euthanized and visually inspected for the presence of abdominal adhesions. Results: There were no detectable adhesions in animals treated with vCUT at all study time-points. Furthermore, histological analysis of peritoneum, cecum, and/or vCUT tissues was performed. Adhesion, inflammation, and fibrosis were scored on a scale of 0-4. Scores were lower at days 28 and 74 in the vCUT group versus the control group (1.79 + 0.89, p<0.0001, n=8). Although degraded over time, vCUT on the peritoneal wall persisted up to 74days providing adequate time for surgical wounds to heal. Conclusions: vCUT decreased formation of postoperative adhesions in vivo in a rabbit abdominal adhesion model. This data supports the use of vCUT as an adhesion barrier in surgical procedures.
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