(J-367) Decellularized Porcine Serosal Grafts for Prevention of Post-Operative Intestinal Adhesions

Introduction:: Intra-abdominal adhesions, also known as postoperative peritoneal adhesions, refer to the formation of abnormal tissue attachments between organs and the peritoneum following surgery. They can also manifest as a consequence of tissue trauma caused by other factors like peritoneal tissue irritation after an infection. Postoperative adhesions pose a significant burden on the healthcare industry, with over 90% of gastrointestinal surgical procedures resulting in adhesion formation, regardless of the location or surgical technique used. Adhesions can lead to other secondary issues like chronic abdominal pain, intestinal obstructions, infertility, morbidity & mortality. In the present work, we describe the development of a novel decellularized extracellular matrix (ECM) based biomaterial derived from porcine small intestine tissue to prevent postoperative peritoneal adhesions.


Materials and Methods:: The serosal layer was extracted from porcine small intestine tissue by mechanical dissociation. Following this, the serosal tissue was processed through various steps by incubation in chloroform-methanol, trypsin-EDTA & SDS-NaCl solutions for decellularization. The tissue was sterilized by treatment with peracetic acid and ethanol. Finally, the serosal tissue was lyophilized to obtain the ‘Serografts.’ Various tests were conducted to characterize the properties of Serografts, such as Young’s Modulus (YM), Dynamic Mechanical Analysis (DMA), Fourier Transform Infrared Spectroscopy (FTIR), etc. Scanning Electron Microscopy (SEM) was used to examine the surface/ topological features of the Serografts. Histological examination was performed on the native and decellularized tissues using H&E staining, Masson’s Trichrome staining, and Alcian Blue/ Periodic-Acid Schiff’s staining to validate the decellularization process and also to observe the distinct structures in the tissue. Immunofluorescence studies were carried out to corroborate the presence of various proteins in the decellularized ECM. Finally, the generated Serografts were examined for their anti-adhesive potential under different ex-vivo and in-vivo conditions.


Results, Conclusions, and Discussions:: Results and Discussion: The Serografts produced after the decellularization process were devoid of any cells, as indicated through various staining and immunofluorescence techniques. Immunofluorescence studies for different ECM proteins showed the abundance of Collagen IV in the decellularized tissues, followed by Collagen I and trace quantities of Elastin and Laminin. This indicates that Collagen IV made the bulk of the serosal layer after decellularization was completed. The FTIR examination showed similar spectra for Serografts and Cook Biotech SIS (a commercially available decellularized small intestine submucosa product). Mechanical tests pointed out that the material is viscoelastic in nature. There was only a ~1-1.5 fold increase in the swelling ratio of Serografts over a period of 14 days, which was comparable to the swelling ratio obtained for Cook Biotech SIS. Ex-vivo examinations for the anti-adhesive properties of Serografts indicated better performance as compared to Seprafilm (a commercial anti-adhesive product).



Conclusion: Based on the results obtained in this study, the decellularized serosal ECM-based biomaterial, ‘Serograft’ demonstrated superior anti-adhesive properties as compared to a commercial product. Successful decellularization was validated through various staining techniques, and the preservation of ECM proteins post-decellularization was confirmed via immunofluorescence studies. The surface topological examination via SEM identified the presence of collagen fibers. Future work will involve evaluating the biomaterial for other applications such as wound healing, tissue repair, and delivery of bioactives.

Acknowledgements (Optional): :

References (Optional): :