Evaluation of polylactide film for prevention of pericardial adhesion in a rabbit model

OZ Amac: Bu calismada pelvik yapisikliklari onlemede etkinligi kanitlanmis biyoemilebilir polilaktid bariyerin ameliyat sonrasi perikardiyal yapisikliklari onlemedeki etkinligi bir hayvan modelinde degerlendirildi. Ca­lis­ma­ pla­ni:­ Kirk Yeni Zelanda beyaz tavsani esit olarak kontrol ve tedavi gruplarina ayrildi. Deneklere sol anterior torakotomi ve parsiyel perikardiyektomi sonrasi epikardiyal abrazyon uygulandi. Kontrol gruplarinda (grup 1 ve 2) retrosternal yapisikliklara izin vermek icin perikard acik birakildi. Tedavi gruplarinda ise (grup 3 ve 4) perikardiyal defekt 0.02 mm biyoemilebilir polilaktid bariyer ile kapatildi. Ameliyat sonrasi makroskopik ve mikroskopik degerlendirmeler gruplar hakkinda bilgisi olmayan degerlendirmeciler tarafindan grup 1 ve 3’te ucuncu haftanin sonunda, grup 2 ve 4’te ise altinci haftanin sonunda yapildi. Bul gu lar: Makroskopik ve histopatolojik degerlendirmeler kontrol ve tedavi gruplari arasinda adezyon gelisimi acisindan anlamli farklilik olmadigini gosterdi. Ancak polilaktid bariyer tedavi gruplarinda mezotelyum benzeri hucre tabakasinin gelisimini destekledi. So­nuc:­ Polilaktid bariyer mezotel hucre tabakasinin rejenerasyonuna yardimci olsa da perikardiyal yapisikliklarin gelisimini onlememektedir. Anah­tar­ soz­cuk­ler: Biyoemilebilir polilaktid bariyer; kalp cerrahisi; perikardiyal yapisikliklar. ABSTRACT Background:­This study aims to evaluate the efficacy of a bioabsorbable polylactide film, which was proven to be effective in preventing pelvic adhesions, in prevention of postoperative pericardial adhesions in an animal model. Methods: Forty New Zealand white rabbits were divided equally into control and treatment groups. Subjects were performed left anterior thoracotomy and partial pericardiectomy followed by epicardial abrasion. In control groups (group 1 and 2), the pericardium was left open to allow retrosternal adhesions. In treatment groups (group 3 and 4), the pericardial defect was closed with 0.02 mm bioabsorbable polylactide film. Postoperative macroscopic and microscopic evaluations were made by the same blinded observers at the end of the third week in group 1 and 3, and at the end of the sixth week in group 2 and 4. Results:­ Macroscopic and histopathologic examinations revealed no significant differences between control and treatment groups in terms of adhesion formation. However, polylactide film supported the growth of a mesotheliumlike layer in the treatment groups. Conclusion:­ Although polylactide film assists in the regeneration of mesothelial cells layer, it does not prevent the development of pericardial adhesions.