Intrathoracic retention of insoluble hyaluronic acid and its absorption process in rats

Abstract

Background: Post-thoracotomy adhesions are frequent postoperative complications. It has been reported that insoluble hyaluronic acid may prevent adhesions. Materials and methods: This study had two objectives: first, to determine the in vivo degradation and absorption process, as well as the intrathoracic retention, of solid insoluble hyaluronic acid membrane; and second, to elucidate the association between postoperative intrathoracic retention and the morphological changes of insoluble hyaluronic acid in 12 Wistar rats. Insoluble hyaluronic acid membranes were cut into 2.0 cm × 1.0 cm rectangles in a dry state. After weighing, the test membranes were soaked and washed with saline to be implanted after pericardiotomy via thoracotomy. At Days 4, 7, 10, 14, and 28 after implantation, the rats were euthanized, the chest was opened, and the condition and implantation site of the inserted test membrane were examined. Results: Although approximately 10 days were required for the test membrane to decrease to half in the thoracic cavity, the intrathoracic remnant decreased to a mean of ~2% just 4 days later. Conclusion: This study clarified the time-dependent degradation process and remnants of insoluble hyaluronic acid in the thoracic cavity. A close relationship between the intrathoracic remnant of insoluble hyaluronic acid and its morphological change associated with degradation was demonstrated.