Preventing postoperative tissue adhesion using injectable carboxymethyl cellulose-pullulan hydrogels.

An injectable adhesive hydrogel composed of carboxymethyl cellulose (CMC) and pullulan is developed and evaluated as a postoperative anti-adhesion barrier. CMC was modified with tyramine to introduce crosslinking site via an EDC-NHS reaction. The in situ hydrogel was prepared by an enzyme-mediated reaction of tyramine-immobilized CMC with horseradish peroxidase (HRP) and hydrogen peroxide (H2O2). Pullulan was added to the hydrogel solution to improve adhesiveness to the wound area and accelerate biodegradation. The modified CMC was confirmed by ATR-FTIR spectroscopy. The gelation time, storage modulus (G'), and weight loss of the hydrogels were measured as functions of the amounts of HRP and H2O2. The hydrogel group showed negligible cell proliferation and cytotoxicity, compared to that shown by the control group. The in vivo animal test demonstrated that significant decrease of postoperative tissue adhesion by applying the hydrogels. The CMC-pullulan hydrogel could be a useful treatment as an injectable in situ anti-adhesive agent.