Biodegradable N, O-carboxymethyl chitosan/oxidized regenerated cellulose composite gauze as a barrier for preventing postoperative adhesion

Tissue adhesion is one of the most common complications after surgery (especially after abdominal surgery), causing notable influences after the damaged tissue has healed. A physical barrier placed between the wound site and the adjacent tissues is a convenient and highly effective technique to minimize or prevent abdominal adhesions. In this work, the N, O-carboxymethyl chitosan/oxidized regenerated cellulose (N, O-CS/ORC) composite gauze was prepared. The N, O-CS/ORC composite gauze is degradable; in addition, the gauze exhibits excellent antimicrobial functionality against S. aureus and E. coli bacteria. Moreover, the notable hemostatic efficacy of the N, O-CS/ORC composite gauze was confirmed in rabbit livers/ears as models. The results showed that the N, O-CS/ORC composite gauze is nontoxic toward normal cells and can restrain the adhesion of fibroblast cells, thereby indicating its potential use in preventing tissue adhesion. In addition, the rat models for abdominal defect-cecum abrasion were used to evaluate the efficacy of N, O-CS/ORC composite gauze in preventing tissue adhesions after surgery. The results indicated that the N, O-CS/ORC composite gauze can significantly prevent postsurgical peritoneal adhesions. Finally, the potential anti-adhesion mechanism of the N, O-CS/ORC composite gauze, which may attribute to the combination of barrier function and instinct activity of N, O-CS and ORC, was investigated.