Document Detail

Hydrogel protection: a novel approach to reduce bowel inflammation in experimental gastroschisis.
MedLine Citation:
PMID:  19900744     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In gastroschisis there is herniation of the fetal bowel into the amniotic cavity that results in severe intestinal dysfunction. In order to reduce bowel exposure to amniotic fluid we used a hydrogel of N-isopropylacrylamide copolymerized with acrylic acid (P(NIPAAm-co-AAc)) to coat the herniated bowel through the use of a fibrin adhesive (Beriplast). STUDY DESIGN: Gastroschisis was created in fetuses of 31 pregnant Sprague-Dawley rats by evisceration of the bowel through a right paramedian incision in the abdominal wall on day 18.5 of pregnancy. The fetuses were separated in four groups of 12 fetuses: control (C), gastroschisis (G), gastroschisis+fibrin adhesive (GA) and gastroschisis+fibrin adhesive+dry hydrogel (GAH). Animals were harvested at day 21.5 of pregnancy and the hydrogel was removed. Fetuses and bowels were weighed and morphometric analysis was performed. Isoelectric focusing of the amniotic fluid determined its electrical charge. We evaluated the hydrogel swelling ratio (Q) in the amniotic fluid. Histological analysis and scanning electronic microscopy (SEM) of the bowel and hydrogel were performed. Our primary outcome was bowel intactness after hydrogel removal and our secondary outcome was the effectiveness of the hydrogel in protecting the bowel against amniotic fluid and its components. Differences among the groups were tested by the ANOVA and Tukey-Kramer post-test method and the statistical significance accepted was for p values <0.05. RESULTS: The mass of swollen hydrogel was 34 times the mass of dry hydrogel. Isoelectric focusing of the amniotic fluid showed that most of its proteins are negatively charged as the hydrogel. SEM showed that removal of the hydrogel did not damage bowel serosa. Bowel weight, diameter and wall thickness were similar between groups C and GAH but bowel diameter and wall thickness was significantly reduced in C and GAH compared to G and GA (p<0.001). CONCLUSION: The P(NIPAAm-co-AAc) hydrogel does not harm the bowel and provides a safe effective protection with reduction of bowel damage in gastroschisis.
Frances Lilian Lanhellas Gon?alves; Regiane da Silva; Augusto Frederico Schmidt; Marcelo Ganzarolli de Oliveira; Louren?o Sbragia
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  148     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  35-9     Citation Subset:  IM    
Division of Pediatric Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, UNICAMP, CP 6111, Campinas, SP, Brazil.
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MeSH Terms
Acrylamides / therapeutic use*
Amniotic Fluid / chemistry
Fibrin Tissue Adhesive / therapeutic use
Gastroschisis / complications*,  drug therapy*
Hydrogel / therapeutic use*
Inflammation / prevention & control*
Intestines / abnormalities
Isoelectric Focusing
Microscopy, Electron, Scanning
Models, Animal
Polymers / therapeutic use*
Rats, Sprague-Dawley
Reg. No./Substance:
0/Acrylamides; 0/Fibrin Tissue Adhesive; 0/N-isopropylacrylamide-acrylic acid copolymer; 0/Polymers; 25852-47-5/Hydrogel

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