Table 3.
Materials demonstrating efficacy in human or animal models as per clinical indication of anti-adhesion results.
| Type | Material | Company | Model | Reference |
|---|---|---|---|---|
|
Natural Polymers
(biodegradable) |
||||
| Alginate | Rat (peritoneal) | [233,425] | ||
| HA-mildly crosslinked alginate hydrogel | Rat (peritoneal) | [426] | ||
| Pluronic mixtures/crosslinked alginate | Guardix-SG (Genewel) |
Rat, Rabbit (peritoneal) | [427,428] | |
| Rabbit (pericardial) | [429] | |||
| Rat (pelvic) | [430] | |||
| Human (abdominal) | [431] | |||
| HA-crosslinked alginate (powder) | [432] | |||
| Gelatin | Rat (peritoneal) | [433,434] | ||
| Canine (abdominal) | [435] | |||
| Canine (pelvic) | [436] | |||
| Chitostan-gelatin films | Rat (peritoneal) | [437] | ||
| Gelatin-polyglycolic acid sheets | Canine (pericardial) | [315] | ||
| Genipin-crosslinked gelatin microspheres | Mouse (peritoneal) | [438] | ||
| Gellan Gum | Rat (peritoneal) | [439] | ||
| Poly-γ-glutamic acid | Rat (peritoneal) | [440] | ||
| Fibrinogen/thrombin (Fibrin glue) | Evicel (Johnson & Johnson Medical) | Rat, Rabbit, Human (pelvic) | [441,442,443,444] | |
| Fibrin glue | Canine (pericardial) | [445] | ||
| Hyaluronic Acid (HA) Based | ||||
| Auto-crosslinked HA | Rat (peritoneal) | [446,447,448] | ||
| Human (pelvic) | [236,449] | |||
| Crosslinkable HA derivative-alginate | Rat (peritoneal) | [450] | ||
| Phenolic hydroxyl modified HA hydrogel | Mouse (abdominal) | [451] | ||
| HA-adipicdihydrazide-HA-aldehyde | Rabbit (peritoneal) | [452] | ||
| HA-hydrazide-celluloses-aldehyde [Celluloses: HA, CMC, hydroxypropylmethylcellulose (HPMC), methylcellulose (MC)] | Mouse (peritoneal) | [453] | ||
| Pullan | Rat (peritoneal) | [454] | ||
| Synthetic Polymers | ||||
| Polyethylene glycol (PEG) | Rat (peritoneal) | [455] | ||
| PEG-aliphatic polyester | Rat, Rabbit (abdominal) | [456,457] | ||
| PEG dicarboxylate-poly(ethylene oxide) hydrogel film | Rat (abdominal) | [458] | ||
| Polylactide-PEG tri-block copolymer (PELA) | Mouse, Rat (abdominal) | [459,460] | ||
| Poloxamer 407 (PEG-polypropylene glycol-PEG) | FloGel (Alliance Pharm Co.) | Rat, Hamster, Rabbit (peritoneal) | [428,461,462,463] | |
| PEG-poly(α-hydroxy acid) diacrylate macromers | Rat (peritoneal), Rabbit (pelvic) | [464] | ||
| PEG-chitostan | Rat (peritoneal) | [465] | ||
| PEG-poly(ε-caprolactone)-PEG (PECE) hydrogel | Mouse, Rat (peritoneal) | [466] | ||
| Silicone | Canine (peritoneal) | [467] | ||
| Polyethylene | Rat (peritoneal) | [45] | ||
| Poly(vinyl alcohol) (PVA) | Rabbit (peritoneal) | [468] | ||
| Rat (pericardial) | [469] | |||
| PVA-gelatin membrane | Rat (peritoneal) | [470] | ||
| PVA hydrogel | Porcine, Rat, Human (peritoneal) | [471,472,473] | ||
| Rabbit (abdominal) | [474] | |||
| PVA-coated polyester mesh | Rat (peritoneal) | [475] | ||
| PVA-CMC hydrogel | Rabbit (abdominal) | [476] | ||
| PVA-CMC trilaminar membrane | Rabbit (pericardial) | [477] | ||
| Polylactic acid (PLA) | Rat (peritoneal) | [270,335,465,478] | ||
| Rabbit, Porcine (pericardial) | [314,479] | |||
| PLA nanosheets | Mouse (peritoneal) | [480] | ||
| PLA gel | Human (skin-flap) | [481] | ||
| PLA-PEG copolymer membrane | Rat (Peritoneal, pericardial) | [482] | ||
| Canine (pericardial) | [483] | |||
| PLA-PEG-ePTFE bioresorbable polymer | Rabbit (pericardial) | [484] | ||
| Poly ε-caprolactone (PCLA) | Rat (abdominal) | [485,486] | ||
| Hyaluronic acid-loaded poly(ε-caprolactone) | Rat (abominal) | [487] | ||
| Poly(ε-caprolactone-co-lactide)-bpoly(ethyleneglycol)-b-poly(ε-caprolactoneco-lactide)(PCLA-PEG-PCLA) | Rabbit (peritoneal) | [488] | ||
| Poly(ethylene glycol)-poly (ε-caprolactone)-poly(ethylene glycol) (PEG-PCLA-PEG, PECE) | Rat (peritoneal) | [489] | ||
| Poly(ε-caprolactone)-poly(ethylene glycol)-poly(ε-caprolactone) (PCLA-PEG-PCLA) micelles | Rat (peritoneal) | [490] | ||
| Poly-β-hydroxybutyrate | Bovine, Ovine (pericardial) | [491,492] | ||
| PEG-poly-β-hydroxybutyrate valerate | Rat (peritoneal) | [465] | ||
| Composite Polymers | ||||
| Polyethylene oxide-sodium carboxymethylcellulose gel | Oxiplex/AP Gel (FzioMed) Intercoat (Ethicon) |
Human (pelvic) | [493,494,495,496] | |
| Rat (peritoneal) | [497] | |||
| Silicone-urethane-polyester copolymer | (UBE Sheet, UBE Industries Ltd.) | Canine (pericardial) | [498] | |
| HA-3,3′ -dithiopropionic dihydrazide/PEG diacrylate (HA-DTPH/PEGDA) | Carbylan-SX (Carbylan Biosurgery Inc.) | Rat (peritoneal), Rabbit (pericardial) | [499] | |
| Rabbit (pericardial) | [500] | |||
| Poloxamer-alginate-CaCl2 (gel) | Rabbit (pericardial) | [501] | ||
| Carboxymethyldextranhydrazide-DX-aldehyde | Rabbit (peritoneal) | [427] | ||
| Poly(lactic acid)-poly(oxyethylene-cooxypropylene) (PLA-Pluronic F68) | Rat (peritoneal) | [337] | ||
| d,l-polylactide-ε-caprolactonetrimethylenecarbonate (PCT co-polymer) | Rat (peritoneal) | [370] | ||
| Monomethoxy poly(ethylene glycol)-poly(lactic acid) hydrogel | Rat (abdominal) | [502] | ||
| PLGA-poly(lactide-co-caprolactone) (PLCA)-poly(L-phenylalanine-co-p-dioxanone (PDPA) film | Rabbit (abdominal) | [503] | ||
| Oxidized regenerated cellulose-polypropylene-poly(ε-caprolactone) | Rat (abdominal) | [504] | ||
| Drug-Loaded Composite Polymers | ||||
| Antibiotics | ||||
| Cefoxitin sodium in PLGA/PEG-PLA membrane (nanofibrous sheet) | Rat (peritoneal) | [412] | ||
| Ornidazole in PCL (nanofibrous sheet) | Rat (peritoneal) | [486] | ||
| Chloramphenicol in dextran (solution) | Rat (peritoneal) | [505] | ||
| Anti-coagulant (Heparin) | ||||
| Heparin in Interceed | Rabbit, human (peritoneal) | [240,506] | ||
| Heparin in Seprafilm | Rat (peritoneal) | [507] | ||
| Heparin in collagen | Canine (peritoneal) | [508] | ||
| Anti-inflammatory | ||||
| Ibuprofen in PLLA-PEG copolymer (dense or nanofibrous sheet) | Rat (peritoneal) | [410] | ||
| Ibuprofen in pluronic mixtures-crosslinked ALG (hydrogel) | Rat (peritoneal) | [428] | ||
| Ibuprofen in poly(lactic-co-glycolic acid) (nanofibrous mesh) | Mouse (abdominal) | [509] | ||
| Ibuprofen in PVA cryobarrier | Rat (abdominal) | [510] | ||
| Dexamethasone in poly(lactide-co-glycolide) microparticles | Rat (peritoneal) | [511] | ||
| Dexamethasone in PLA-PEG copolymer | Rabbit (pericardial) | [512] | ||
| Budesonide in cross-linking HA (hydrogel) | Rabbit (abdominal) | [513] | ||
| Tolmetin in HA | Rat (abdominal) | [170] | ||
| Naproxen nanoparticles in chitosan hydrogel | Rat (abdominal) | [417] | ||
| Atorvasain in Seprafilm (sheet) | Rat (peritoneal) | [514] | ||
| Vitamin E/Seprafilm (sheet) | Rat (peritoneal) | [515] | ||
| Methylene blue in polyhydroxybutyrate (nanofiber sheet) | Rat (abdominal) | [174] | ||
| Fibrinolytic Agents | ||||
| tPA in Interceed | Rat (peritoneal) | [516] | ||
| tPA in HA-adipic dihydrazide-HA-aldehyde (hydrogel) | Rabbit (peritoneal) | [517] | ||
| Tranilast-encapsulated polydioxanone fiber in CMC (hydrogel) | Rabbit (peritoneal) | [518] | ||
| Streptokinase in polyhydroxybutyrate-co-hydroxyvalerate membrane | Rat (peritoneal) | [215] | ||
| Anti-Cancer and Anti-Tumour Drugs | ||||
| Paclitaxel in crosslinked HA | Rat (peritoneal) | [519] | ||
| Doxorubicin in poly(ethylene glycol)-poly(ε-caprolactone)-poly(ethylene glycol) (PECE) copolymer | Mouse (peritoneal) | [520] | ||
| Mitomycin C in crosslinked HA (hydrogel) | Rat (abdominal) | [225] | ||
| Rapamycin in poly(ε-caprolactone)-poly(ethylene glycol)-poly(ε-caprolactone) (PCL-PEG-PCL) (sheet) | Porcine (pericardial) | [521] | ||
| Growth Factors | ||||
| Keratinocyte growth factor (KGF) in N,O-carboxymethyl chitosan (hydrogel) | Rat (abdominal) | [522] | ||
| Epidermal growth factor (EGF) in gelatin (sheet) | Porcine (pericardial) | [523] | ||
| Other Drugs | ||||
| Tranilast in sodium carboxymethylcellulose (sheet) | Rabbit (abdominal, pelvic) | [524] | ||
| Ginsenoside Rg1 in acellular bovine pericardium | Rabbit (pericardium) | [525] | ||
| Fibrin in agarose hydrogel patch | Rat (abdominal) | [526] |