@phdthesis{Kessler2015,
  author    = {Keßler, Martina},
  title     = {Biodegradable solvent cast films and solution electrospun meshes for the prevention of postsurgical adhesions},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-129358},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Intraperitoneal adhesions are fibrous bands that connect tissues in the peritoneal cavity that are usually separated. These adhesions form as a consequence of trauma, inflammation or surgical interventions and often result in severe consequences such as chronic pain, small bowel obstructions or female infertility. The aim of this thesis was to develop a synthetic barrier device for adhesion prevention made of modified poly(lactide) [PLA]. Solid PLA films (SurgiWrap®) are already successfully in clinical use due to the good biocompatibility and the biodegradability of the material resulting in non-toxic degradation products since lactic acid is naturally part of the metabolic circles of the human body. Considering the brittleness and stiffness of the films, the long degradation time of several months as well as the need for suturing, there is potential for optimization. Through a copolymerization with the hydrophilic poly(ethylene glycol) [PEG], a reduction of the degradation time was intendend. Moreover, the copolymerization should also lead to an improvement of the mechanical properties of the films since PEG acts as plasticizer for PLA. Linear PLA-PEG-PLA triblock copolymers as well as star-shaped PEG-PLA copolymers were synthesized via standard ring opening polymerization to tailor the barrier properties. Besides solid films, solution electrospun meshes from PLA and the synthesized PEG-PLA copolymers were investigated for a potential application as well. Since suturing of a barrier additionally induces adhesion formation, alginate coated membranes were prepared in order to achieve self-adhesiveness. With the intention to reduce infections and consequently inflammation, electrospun meshes and solvent cast films were loaded with the antibacterial drug triclosan and drug release as well as antibacterial efficacy was investigated. Mechanical tests confirmed that through the variation of the PEG content and branching the mechanical properties can be tailored and are in good accordance with the glass transition temperatures [Tg] of the polymers. Consequently, potentially adequate mechanical properties for surgical handling as well as for the performance within the patient's body were successfully achieved. Degradation studies revealed that the degradation time was significantly shorter for PEG-PLA membranes than for PLA films and with an appropriate PEG content could be adjusted to the intended time frame. Cell adhesion and viability tests confirmed the non-toxicity of the clinically used PLA films as well as of PEG-PLA films and meshes. With a bioadhesion test the benefit of an alginate coated side towards the pure PLA film concerning self-adhesiveness was successfully demonstrated. Moreover, optical evaluations and a T-peel test of different alginate coated PLA films showed that the cohesion between the chemically different layers was distinctly enhanced by the use of an appropriate PEG-PLA mesh as intermediate cohesion promoting layer. In in vitro release studies with triclosan loaded films a higher release was determined for PEG-PLA than for PLA films. In agar diffusion tests a higher and longer inhibition of staphylococcus aureus growth was observed confirming the release results. Moreover, drug loaded meshes (especially drug loaded after electrospinning) showed enhanced and elongated bacterial inhibition in comparison to films.},
  subject      = {Polymere},
  language  = {en}
}