{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:44:55Z","timestamp":1791942295154,"version":"4.3.4"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Biomedical Materials Res"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Postsurgical adhesions are a common complication associated with surgical procedures; they not only impact the patient's well\u2010being but also impose a financial burden due to medical expenses required for reoperative surgeries or adhesiolysis. Adhesions can range from a filmy, fibrinous, or fibrous vascular band to a cohesive attachment, and they can form in diverse anatomical locations such as the peritoneum, pericardium, endometrium, tendons, synovium, and epidural and pleural spaces. Numerous strategies have been explored to minimize the occurrence of postsurgical adhesions. These strategies include surgical approaches, adhesiolysis, antiadhesive agents, and mechanical barriers which have demonstrated the most promise in terms of efficacy and breadth of indications. In this review, we discuss the use of physical\/mechanical barriers for adhesion prevention and outline the most commonly used, commercially available barriers. We then focus on a synthetic, dual\u2010polymer gel composed of carboxymethyl cellulose (CMC) and poly(ethylene oxide) [PEO], which, unlike the more commonly used single\u2010polymer hydrogels, has demonstrated higher efficacy across a greater range of indications and surgical procedures. We review the formulation, mechanical properties, and mechanisms of action of the CMC\u2009+\u2009PEO dual\u2010polymer gel and summarize findings from clinical studies that have assessed the efficacy of CMC\u2009+\u2009PEO gels in multiple surgical settings in clinics across the world. In conclusion, the CMC\u2009+\u2009PEO dual\u2010polymer gel represents an approach to preventing postsurgical adhesions that has been commonly used over the last 20\u2009years and could therefore serve as a foundation for research into improving postsurgical outcomes as well as a drug delivery device to expand the use of gels in surgical settings.<\/jats:p>","DOI":"10.1002\/jbm.a.37852","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T02:58:51Z","timestamp":1735095531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Dual\u2010Polymer Carboxymethyl Cellulose and Poly(Ethylene Oxide)\u2010Based Gels for the Prevention of\u00a0Postsurgical Adhesions"],"prefix":"10.1002","volume":"113","author":[{"given":"Anisha A.","family":"DSouza","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences Northeastern University  Boston Massachusetts USA"},{"name":"Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6170-881X","authenticated-orcid":false,"given":"Mansoor M.","family":"Amiji","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences Northeastern University  Boston Massachusetts USA"},{"name":"Department of Chemical Engineering, College of Engineering Northeastern University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/7.6.567"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom11071027"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-16893-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-007-0338-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmv021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.54403"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/btm2.10565"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)47768-X"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196804000-00006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.11.2832"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2020.02.53"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dml061"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.30659"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00298-1"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2018.02.001"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma3053331"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2004.16.3.3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101157"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.10211"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(03)00035-4"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-7922-8-6"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.progpolymsci.2014.10.004"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11061476"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.08.005"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2010.10.037"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31829ec889"},{"key":"e_1_2_9_28_1","volume-title":"Response to Citizen Petition","author":"Flannery E. J.","year":"2021"},{"key":"e_1_2_9_29_1","first-page":"42","article-title":"New Use of an Absorbable Adhesion Barrier (INTERCEED) for Temporary Diverting Ileostomy in Minimally Invasive Rectal Surgery","volume":"42","author":"Nagasaki T.","year":"2022","journal-title":"Journal of Coloproctology"},{"issue":"9","key":"e_1_2_9_30_1","first-page":"766","article-title":"Effect of Thrombin\u2010Induced Hemostasis on the Efficacy of an Absorbable Adhesion Barrier","volume":"37","author":"Wiseman D. M.","year":"1992","journal-title":"Journal of Reproductive Medicine"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac075"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2017.07.103"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00642-1"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000062354.26905.B8"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1164-2-2"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2011.09.034"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104314"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)47909-4"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2021.11028"},{"key":"e_1_2_9_40_1","unstructured":"H. E.Schwartz J. M.Blackmore S. M.Cortese W. G.Oppelt G.Dizegera andFzioMed Inc Assignee \u201cCompositions of Polyacids and Polyethers and Methods for Their Use in Reducing Pain \u201d2004."},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ceramint.2022.12.118"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182309af7"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodchem.2017.07.134"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2019.04.079"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2008.12.014"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B2.0840196"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.07.1505"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.04.055"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh651"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2011.04.007"},{"issue":"1","key":"e_1_2_9_51_1","first-page":"5","article-title":"Uterine Septoplasty and Adhesiolysis: Difficult Hysteroscopic Surgery and Intrauterine Carboxymethyl Cellulose + Polyethylene Oxide Dual Polymer Gel Resulted in Good Clinical Outcomes: Three Case Reports","volume":"8","author":"Cunha V. M.","year":"2024","journal-title":"Journal of Clinical Obstetrics, Gynecology and Infertility"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2013.07.019"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2004.17.1.8"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2004.09.025"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817e30fb"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e3182a35590"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsg.2019.11.003"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hansur.2018.10.244"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-019-0261-2"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.08.029"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002480-200011000-00003"},{"key":"e_1_2_9_62_1","article-title":"Barrier Agents for Adhesion Prevention After Gynaecological Surgery","volume":"2015","author":"Ahmad G.","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1586\/erd.09.55"}],"container-title":["Journal of Biomedical Materials Research Part A"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbm.a.37852","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jbm.a.37852","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbm.a.37852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:55:27Z","timestamp":1791939327000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jbm.a.37852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":62,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/jbm.a.37852"],"URL":"https:\/\/doi.org\/10.1002\/jbm.a.37852","archive":["Portico"],"relation":{},"ISSN":["1549-3296","1552-4965"],"issn-type":[{"value":"1549-3296","type":"print"},{"value":"1552-4965","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,24]]},"assertion":[{"value":"2024-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e37852"}}