Curcumin polymeric membranes for postoperative peritoneal adhesion: Comparison of nanofiber vs. film and phospholipid-enriched vs. non-enriched formulations

Abstract

Intra-abdominal adhesion remains a major postoperative problem and is able to place individuals at lifelong risk of serious complications. Among available approaches, insertion of a barrier membrane at the site of injury partially inhibited adhesion formation. Moreover, the local administration of an anti-adhesive agent showed some favorable effects. In this study, we aimed to prepare and fully characterize polycaprolactone (PCL)-based film casts and electrospun nanofibers (NFs) containing a natural anti-inflammatory agent, curcumin (CUR), with extended-release properties. We also compared their efficiencies in preventing tissue adhesions. Additionally, the impact of soy phosphatidylcholine (SPC) enrichment on adhesion prevention was investigated. Prepared membranes were evaluated in terms of surface morphology (SEM, AFM), surface wettability, CUR release profiles, structural properties (FTIR, XRD, DSC), and mechanical behaviors. To further analyze the anti-adhesion effectiveness, a cecal abrasion model was performed on rats. SEM and AFM images showed a smoother surface in SPC-containing films. Concerning NFs, uniform bead-free fibers were observed and SPC containing NFs showed higher conductivity and lower viscosity and therefore, smaller fibers. All formulations exhibited sustained drug release over 4 weeks. In vivo findings revealed the superior performance of films compared to NFs and phospholipid-enriched formulations over non-enriched ones. Among all film formulations and in comparison to the positive control (Seprafilm®), CUR-SPC-PCL films significantly reduced peritoneal adhesions, as evidenced by gross examination, histological evaluation and immunohistochemical (IHC) analysis. The remarkable in vivo anti-adhesion activity together with suitable in vitro properties have made CUR-SPC-PCL films a promising system for postoperative anti-adhesion purposes in the clinic.

Keywords: Curcumin; Films; Intra-abdominal adhesions; Nanofibers; Phospholipid; Polycaprolactone.