Bioactive implants as adhesion barrier
In the course of this project, an absorbable, biocompatible and minimally invasive adhesion barrier will be developed. The inversion principle will be used, in which a matrix for non-vascular tissue formation, such as cartilage tissue, is used to prevent vascular scar formation and thus adhesion.
The medical goal is the development of a bioactive adhesion barrier as an implant. 60-90% of all abdominal surgeries lead to pathological adhesions. Chronic pain, infertility and lethal intestinal obstructions can be the consequences. Several membranous and liquid adhesion barriers applied between injured tissue surfaces are clinically approved but do not find general acceptance due to insufficient efficacy. To prevent adhesions, an ideal adhesion barrier should be minimally invasive (liquid) in application, adaptable to any tissue topography, exhibit excellent biocompatibility, not allow inflammation, vascularization, and scar tissue formation, and be resorbed after a few weeks. Furthermore, an adhesion barrier should be inexpensive, storage stable and easy to handle. The international adhesion barrier market is estimated to be approximately $500 million, given 1.6 million gynecologic procedures in the U.S. alone in 2000.
Based on a biological antagonism of matrix molecules towards different cell types, a novel inversion principle is to be implemented in this project: an implant matrix suitable for vascular tissue formation (e.g. cartilage) should, in turn, suppress vascular-dependent scar formation (here mainly adhesion between different tissue surfaces in the abdominal cavity), since the cells involved in each case exhibit opposite (= inverted) cell-matrix dependencies. In fact, we were able to demonstrate in pilot experiments that a special albumin-based hydrogel shows exactly these properties, as on the one hand cartilage tissue is promoted, but on the other hand adhesion formation in the abdominal cavity is prevented. The aim of the project is a) to further develop chemical/technical properties of the hydrogel into an anti-adhesive inversion gel (InGel) and b) to develop precisely adapted minimally invasive application instruments.