Poster BB14 - Decellularized Porcine Serosal Grafts for the Prevention of Post-Surgical Intestinal Adhesions

Introduction: Post-operative peritoneal adhesions, another name for intra-abdominal adhesions, are abnormal tissue attachments that occur after surgery between organs and the peritoneum. They may also show up as the result of tissue damage caused by other factors, such as inflammation of the peritoneal tissue, following an infection. Regardless of the location or surgical approach, approximately 90% of gastrointestinal surgical procedures result in the development of post-operative adhesions, which represent a significant burden for the healthcare sector. Adhesions may cause infertility, intestinal obstructions, persistent abdominal discomfort, morbidity, and mortality, among other secondary problems. In this study, we demonstrate the generation, assessment, and characterization of a novel biomaterial based on a decellularized extracellular matrix (ECM) that was obtained from small intestinal tissue of pigs and is intended to avoid peritoneal adhesions following surgery.

Materials and

Methods: The outermost layer, known as the serosal layer, was mechanically separated from the small intestine of porcine origin. Following that, the serosal tissue underwent several treatments for decellularization by incubation in solutions containing chloroform-methanol, SDS-NaCl, and trypsin-EDTA. By treating the tissue with ethanol and peracetic acid, the tissue was sterilized. Ultimately, the decellularized biomaterial known as "Serografts" was obtained by lyophilizing the serosal tissue. Tensile strength, Fourier Transform-Infrared (FTIR) Spectroscopy, and Dynamic Mechanical Analysis (DMA) were used to assess the physicochemical features of serografts. Scanning electron microscopy (SEM) was used to observe the surface and topological characteristics of serografts. To confirm the decellularization process and identify the unique structures in the tissue, histological examinations using Masson's Trichrome, Alcian Blue/Periodic-Acid Schiff's, and H&E staining were conducted on the native and decellularized tissues. Studies using immunofluorescence were conducted to confirm that different proteins were present in the decellularized extracellular matrix. Following this, the anti-adhesive nature of Serografts was tested with the help of ex-vivo tests. Lastly, several models of abdominal adhesion were tested to obtain robust and reliable adhesions and Serograft was tested in the most-reliable model of all.

Results, Conclusions, and Discussions: The Serografts that were generated following the decellularization procedure were found to be acellular, as demonstrated by several staining and immunofluorescence methods. Collagen IV was shown to be abundant in the decellularized tissues, followed by Collagen I and trace amounts of Elastin and Laminin, according to immunofluorescence investigations for several ECM proteins. Serografts and a commercially available decellularized small intestine submucosa product had comparable FTIR spectra. According to mechanical tests, the behavior of serografts is essentially elastic. In this work, we present Serograft, a novel decellularized biomaterial made of porcine intestines. Using a variety of staining methods, successful decellularization was verified, and immunofluorescence tests verified the preservation of ECM proteins after decellularization. The SEM surface topological analysis revealed the existence of collagen fibrillar structures. Serografts outperformed a commercial product in terms of anti-adhesive properties. When tested in vivo, Serograft demonstrated significantly improved anti-adhesive qualities as compared to a commercial control in a model of post-operative peritoneal adhesion. The evaluation of serografts as an antiadhesive biomaterial for various surgical applications and local therapeutic administration is an ongoing study.

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