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  • http://hdl.handle.net/10402/era.25195
  • Development of a Sirolimus-eluting Mesh to Reduce Intra-Abdominal Adhesions
  • Maciver, Allison H
  • English
  • adhesions
    surgery
    sirolimus
  • Jan 17, 2012 3:42 PM
  • Thesis
  • English
  • Adobe PDF
  • 2788823 bytes
  • 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.
  • 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.2011.08.008
    A version of Chapter 2 was published in the journal SURGERY. 2011, Nov;150(5):907-15.
  • Master's
  • Master of Science
  • Department of Surgery
  • Experimental Surgery
  • Spring 2012
  • Dr. A.M.J. Shapiro, Department of Surgery
  • Dr. T.A. Churchill, Department of Surgery
    Dr. D.L. Bigam, Department of Surgery
    Dr. C.W. Teshima, Department of Medicine