Verteporfin-loaded sutureless composite barrier: A novel approach to peritendinous adhesion prevention

Peritendinous adhesion is one of the most common postoperative or posttraumatic complications of tendon injury, which severely limits functional rehabilitation and raises the risk of re-rupture. This study prepared a multifunctional composite composed of a "sandwich" electrospun nanofibrous membrane with sustained drug release property and adhesives for sutureless application. The composite was assessed here through microscopic, spectroscopic, wettability, rheological, mechanical, and drug release analyses. The results of these characterizations are consistent with the characteristics of anti-adhesion biomaterials. In addition, the anti-adhesion effectiveness was demonstrated in fibroblasts and rats. Briefly, the composite not only decreased the proliferation, viability, and penetration of fibroblasts but also repressed cell spreading on the material surface by regulating Yes-associated protein (YAP) and inhibited oxidative stress by scavenging reactive oxygen species (ROS) simultaneously in vitro. Meanwhile, histological analysis, functional tests, gross observation, and protein analysis in vivo showed that composite was effective in reducing tendon adhesion formation. Hence, we draw the conclusion that our composite can protect tendons from peritendinous adhesion after injury and provide a new direction for future application of peritendinous anti-adhesion. & COPY; 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).