A new absorbable collagen membrane to reduce adhesions in cardiac surgery
Alain Bel 1*,
Levon Kachatryan 1,
Patrick Bruneval 1,
Severine Peyrard 1,
Christian Gagnieu 2,
Jean-Noel Fabiani 1,
Philippe Menasche 1
1 European Hospital Georges Pompidou, Paris, France
2 University Claude Bernard, Lyon, France
* To whom correspondence should be addressed. E-mail: alain.bel{at}egp.aphp.fr.
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Abstract |
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Reduction of sternal adhesions is still an issue in cardiac surgery. To evaluate a new fibrillar porcine collagen absorbable membrane (CovaTM CARD), sixteen sheep underwent a sternotomy followed by scratching of surface of the heart. They were then divided into three groups: pericardium left opened (n=4), placement of Seprafilm®, the reference absorbable substitute, (hyaluronic acid and carboxymethylcellulose, n=6) or of CovaTM CARD membrane (n=6). Four months thereafter, the animals underwent repeat sternotomy and were macroscopically assessed for the degree of resorption of the material and the intensity of adhesions. Explanted hearts were blindly evaluated for the magnitude of the inflammatory response and fibrosis. The CovaTM CARD membrane was almost totally absorbed by 4 months and replaced by a loosely adherent tissue. There was no inflammatory reaction and both the extent and density of fibrosis were minimal. The composite score (median [min;max]) integrating tightness of adhesions and histological findings of inflammation and fibrosis was two-fold lower in the CovaTM CARD than in the Seprafilm® group (2.0 [0;3.5] vs. 5.5 [3;7], p = 0.01 by Wilcoxon test). The CovaTM CARD membrane might represent an attractive pericardial substitute for preventing postoperative adhesions in cardiac surgery. Keywords: Biocompatible materials; Reoperation; Surgical adhesions; Collagen membrane
