There is a high prevalence of intra-abdominal adhesions following bowel resection, which can result in chronic pain, bowel obstruction, and morbidity. Although commercial adhesion barriers have been widely utilized for colonic resections, these barriers do not prevent anastomotic leakage resulting from reduced healing of the anastomosis, which can result in long-term health problems. To address this limitation, we have developed an adhesive bilayer wrap with selective bioactivity to simultaneously prevent intra-abdominal adhesion formation and promote anastomotic healing. Reactive electrospinning was used to generate a crosslinked gelatin mesh to serve as a cell-instructive substrate to improve anastomotic healing. A coating of poly(ethylene glycol) (PEG) foam was applied to the bioactive mesh to generate an antifouling layer and prevent intra-abdominal adhesions. After in vitro confirmation of selective bioactivity, the composite wrap was compared after 2 weeks to a commercial product (Interceed^Ⓡ) in an in vivo rat colonic abrasion model for prevention of intra-abdominal adhesions. The composite bilayer wrap was able to prevent intra-abdominal adhesions when clinical placement was maintained. The composite bilayer wrap was further modified to include tissue adhesive properties for improved efficacy. Preliminary studies indicated that the adhesive composite bilayer wrap maintained a maximum shear strength comparable to Interceed^Ⓡ and greater than fibrin glue. Overall, this work resulted in an initial proof-of-concept device that was shown to effectively prevent intra-abdominal adhesion formation in vivo. The composite bilayer wrap studied here could lead to an improved technology for improved healing of intestinal anastomoses.

肠切除术后腹腔内粘连的发生率很高，这会导致慢性疼痛、肠梗阻和发病率。尽管商业粘连屏障已广泛用于结肠切除术，但这些屏障并不能防止因吻合口愈合减少而导致的吻合口渗漏，这会导致长期的健康问题。为了解决这一限制，我们开发了一种具有选择性生物活性的粘性双层包裹物，以同时防止腹内粘连形成并促进吻合口愈合。反应性静电纺丝用于生成交联的明胶网，作为细胞指导基质，以改善吻合口愈合。将聚（乙二醇）（PEG）泡沫涂层应用于生物活性网状物以产生防污层并防止腹腔内粘连。后选择性生物活性的体外确认，2 周后将复合包裹物与商业产品 (Interceed ^Ⓡ )在体内大鼠结肠磨损模型中进行比较，以防止腹内粘连。当维持临床放置时，复合双层包裹物能够防止腹腔内粘连。复合双层包裹物被进一步修改以包括组织粘附特性以提高功效。初步研究表明，粘合复合双层包裹物保持了与 Interceed ^Ⓡ相当且大于纤维蛋白胶的最大剪切强度。总的来说，这项工作产生了一个初步的概念验证装置，它被证明可以有效地防止腹腔内粘连的形成体内。这里研究的复合双层包裹可以导致改进的技术，以改善肠道吻合术的愈合。