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Development of a Sirolimus-eluting Mesh to Reduce Intra-Abdominal Adhesions Open Access


Other title
Type of item
Degree grantor
University of Alberta
Author or creator
Maciver, Allison H
Supervisor and department
Dr. A.M.J. Shapiro, Department of Surgery
Examining committee member and department
Dr. C.W. Teshima, Department of Medicine
Dr. T.A. Churchill, Department of Surgery
Dr. D.L. Bigam, Department of Surgery
Department of Surgery
Experimental Surgery
Date accepted
Graduation date
Master of Science
Degree level
Postoperative intra-abdominal adhesions are a significant clinical problem. This project addresses the potential novel role for a sirolimus-eluting hydrogel in the setting of postoperative adhesions caused by polypropylene hernia repair mesh. We review recent literature on adhesion pathogenesis, and examine the progress in development of anti-adhesion agents and strategies. We hypothesize an antiproliferative and antifibrotic agent such as sirolimus may minimize or prevent the process at critical steps in the pathway. A mouse model was developed using a 1x1 cm2 polypropylene mesh implanted into the peritoneal cavity. This study revealed that the addition of an agarose hydrogel to the adhesiogenic mesh significantly reduced adhesion incidence, severity and tenacity, and adding sirolimus to the hydrogel further significantly reduced adhesion surface area. Sirolimus has been used in many novel clinical settings for its antifibrotic properties; this work supports its consideration with agarose hydrogel as a prophylactic against postoperative intra-abdominal adhesions.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
A version of Chapter 1 was published in The International Journal of Surgery. In press, available online 22 September 2011. doi:10.1016/j.ijsu.2011.08.008A version of Chapter 2 was published in the journal SURGERY. 2011, Nov;150(5):907-15.

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