{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T16:32:07Z","timestamp":1766507527523,"version":"3.48.0"},"reference-count":34,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Taipei University of Technology and Taipei Medical University Joint Research Center","award":["111TN22"],"award-info":[{"award-number":["111TN22"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Polymers"],"abstract":"<jats:p>Background: Postoperative abdominal adhesions are a common and serious complication following abdominal surgery, often leading to chronic pain, bowel obstruction, or infertility. This study aimed to evaluate the efficacy of the new starch-based absorbable hemostatic agent and dressing, BioSight, in comparison with a predicate device (4DryField\u00ae PH) for the prevention of abdominal adhesions in a rat model. Methods: A total of 90 Sprague\u2013Dawley rats were used to establish an intra-abdominal adhesion model and assigned to the BioSight, 4DryField\u00ae PH, or control group. Standardized injuries were created on the cecum and parietal peritoneum, followed by application of the designated materials. Animals were sacrificed at 2, 4, and 12 weeks for macroscopic adhesion scoring and histopathological evaluation. Adhesion area, adhesion strength, and tissue thickness were assessed using established scoring systems, and local healing was examined by H&amp;E staining. All quantitative data were analyzed using one-way ANOVA. Conclusions: In a rat peritoneal adhesion model, BioSight exhibited pronounced anti-adhesion efficacy comparable to 4DryField\u00ae PH. Macroscopic evaluation showed consistently low adhesion scores (\u22640.4) across all time points up to 12 weeks, while histological analysis confirmed reduced adhesion thickness, with BioSight displaying numerically lower values, particularly at early stages (251.3 \u00b1 137.4 \u00b5m vs. 323.2 \u00b1 174.6 \u00b5m at Week 2). This performance is attributed to rapid in situ hydrogel formation that provides effective temporary tissue separation, limits early fibrin deposition and inflammatory cell infiltration, and supports hemostasis. Importantly, the starch-based hydrogel exhibits a balanced biodegradation profile\u2014persisting long enough to protect injured tissues during the critical inflammatory and fibroproliferative phases, yet undergoing complete enzymatic resorption thereafter without adverse tissue reactions. Collectively, these results highlight the anti-adhesion functionality of BioSight and support the clinical potential of plant-derived starch-based bioresorbable surgical adjuncts.<\/jats:p>","DOI":"10.3390\/polym18010033","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:05:22Z","timestamp":1766498722000},"page":"33","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation Starch-Based Hemostatic Agents \u201cBioSight\u201d as Adhesion Prevention Barrier Tested in an Adhesion Model in Rats"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1999-3175","authenticated-orcid":false,"given":"Yi-Xin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"},{"name":"High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Ying","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"},{"name":"High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Hsuan","family":"Yen","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Hwa","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan"},{"name":"Department of Orthopedics, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan"},{"name":"School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan"},{"name":"School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8931-8434","authenticated-orcid":false,"given":"Hsu-Wei","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"},{"name":"High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan"},{"name":"Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli 35053, Taiwan"},{"name":"Institute of Oral Tissue Engineering and Biomaterials, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Anvari-Yazdi, A.F., Badea, I., and Chen, X. (2025). Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering. Gels, 11.","DOI":"10.3390\/gels11060441"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1159\/000441025","article-title":"Evaluation of 4DryField\u00ae PH as Adhesion Prevention Barrier Tested in an Optimized Adhesion Model in Rats","volume":"55","author":"Poehnert","year":"2015","journal-title":"Eur. Surg. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1007\/s11605-017-3488-9","article-title":"Postoperative Abdominal Adhesions: Clinical Significance and Advances in Prevention and Management","volume":"21","author":"Moris","year":"2017","journal-title":"J. Gastrointest. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1007\/s11605-017-3503-1","article-title":"The Primary Result of Prospective Randomized Multicenter Trial of New Spray-Type Bio-absorbable Adhesion Barrier System (TCD-11091) Against Postoperative Adhesion Formation","volume":"21","author":"Suto","year":"2017","journal-title":"J. Gastrointest. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hassanabad, A.F., Zarzycki, A.N., Jeon, K., Dundas, J.A., Vasanthan, V., Deniset, J.F., and Fedak, P.W.M. (2021). Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies. Biomolecules, 11.","DOI":"10.3390\/biom11071027"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1111\/iwj.13939","article-title":"Use of polysaccharide hemostatic agent (HaemoCer\u2122) in breast cancer surgery to reduce postoperative complications: A randomised controlled trial","volume":"20","author":"Falcone","year":"2023","journal-title":"Int. Wound J."},{"key":"ref_7","first-page":"100115","article-title":"Gynecologic postoperative anti-adhesion barriers: From biomaterials to barrier development","volume":"19","author":"MacPhee","year":"2025","journal-title":"Biomater. Biosyst."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kr\u00e4mer, B., Andress, J., Neis, F., Hoffmann, S., Brucker, S., Kommoss, S., and H\u00f6ller, A. (2023). Improvement in Fertility and Pain after Endometriosis Resection and Adhesion Prevention with 4DryField\u00ae PH: Follow-up of a Randomized Controlled Clinical Trial. J. Clin. Med., 12.","DOI":"10.3390\/jcm12103597"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s10397-012-0742-8","article-title":"Seprafilm\u00ae adhesion barrier: (2) a review of the clinical literature on intraabdominal use","volume":"9","author":"Diamond","year":"2012","journal-title":"Gynecol. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1177\/1933719116632923","article-title":"Interceed and Estrogen Reduce Uterine Adhesions and Fibrosis and Improve Endometrial Receptivity in a Rabbit Model of Intrauterine Adhesions","volume":"23","author":"Cai","year":"2016","journal-title":"Reprod. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.7150\/ijms.33277","article-title":"Comparison of adhesion prevention capabilities of the modified starch powder-based medical devices 4DryField\u00ae PH and Arista\u2122 AH in the Optimized Peritoneal Adhesion Model","volume":"16","author":"Poehnert","year":"2019","journal-title":"Int. J. Med. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"424","DOI":"10.7150\/ijms.90024","article-title":"Comparison of adhesion prevention capabilities of the modified starch powder-based medical devices 4DryField\u00ae PH, HaemoCer\u2122 PLUS and StarSil\u00ae in the Optimized Peritoneal Adhesion Model","volume":"21","author":"Poehnert","year":"2024","journal-title":"Int. J. Med. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Choy, K.T., Le, K.D.R., and Kong, J.C.H. (2024). Seprafilm\u00ae and adhesive small bowel obstruction in colorectal\/abdominal surgery: An updated systematic review. BMC Surg., 24.","DOI":"10.1186\/s12893-024-02581-2"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2016.00097","DOI":"10.4293\/JSLS.2016.00097","article-title":"Seprafilm\u00ae application method in laparoscopic surgery","volume":"21","author":"Hong","year":"2017","journal-title":"J. Soc. Laparoendosc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e70887","DOI":"10.1002\/hsr2.70887","article-title":"The efficacy of hyaluronic acid in reducing pelvic adhesions in patients undergoing gynecologic laparoscopic surgery: A meta-analysis of randomized clinical trials","volume":"8","author":"Mazloomi","year":"2025","journal-title":"Health Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"146297","DOI":"10.1016\/j.ijbiomac.2025.146297","article-title":"Development of a sprayable thermosensitive lysine-modified pluronic hyaluronic acid hydrogel for enhanced wound healing and adhesion prevention in laparoscopic applications","volume":"321","author":"Hsu","year":"2025","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3029264","DOI":"10.1155\/2016\/3029264","article-title":"Use of Modified Polysaccharide 4DryField\u00ae PH for Adhesion Prevention and Hemostasis in Gynecological Surgery: A Two-Center Observational Study by Second-Look Laparoscopy","volume":"2016","author":"Korell","year":"2016","journal-title":"BioMed Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e2219024120","DOI":"10.1073\/pnas.2219024120","article-title":"An endoscopically compatible fast-gelation powder forms Janus-adhesive hydrogel barrier to prevent postoperative adhesions","volume":"120","author":"Jia","year":"2023","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s00404-024-07584-1","article-title":"Prevention of peritoneal adhesions after gynecological surgery: A systematic review","volume":"310","author":"Schaefer","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101948","DOI":"10.1016\/j.apmt.2023.101948","article-title":"Shape-adapted self-gelation hydrogel powder for high-performance hemostasis and wound healing","volume":"35","author":"Wang","year":"2023","journal-title":"Appl. Mater. Today"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e21657","DOI":"10.1016\/j.heliyon.2023.e21657","article-title":"Efficacy and safety of purified starch for adhesion prevention in colorectal surgery","volume":"9","author":"Liu","year":"2023","journal-title":"Heliyon"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1080\/01443615.2021.1928030","article-title":"Reduction of adhesion formation after gynecological adhesiolysis surgery with 4DryField\u00ae PH","volume":"42","author":"Ziegler","year":"2021","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sun, J., Fang, T.S., Chen, Y.X., Tsai, Y.C., Liu, Y.X., Chen, C.Y., Su, C.Y., and Fang, H.W. (2023). Improving the Physical Properties of Starch-Based Powders for Potential Anti-Adhesion Applications. Polymers, 15.","DOI":"10.3390\/polym15244702"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Alkatout, I., De Wilde, R.L., Herrmann, J., Klapdor, R., Meinhold-Heerlein, I., M\u00e9sz\u00e1ros, J., Mustea, A., Oppelt, P., Pape, J.M., and Sch\u00e4fer, S.D. (2024). Adhesion Prevention in Gynecologic Surgery: Guidance and Clinical Experience. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247517"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/1553350615610653","article-title":"Adhesions and healing of intestinal anastomoses: The effect of anti-adhesion barriers","volume":"23","author":"Ntourakis","year":"2015","journal-title":"Surg. Innov."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s00011-004-1272-2","article-title":"Camptothecin-loaded films for the prevention of postsurgical adhesions","volume":"53","author":"Cashman","year":"2004","journal-title":"Inflamm Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1080\/08941939.2016.1229367","article-title":"A Novel Method for Evaluating Postoperative Adhesions in Rats","volume":"30","author":"Bove","year":"2017","journal-title":"J. Investig. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1055\/s-0039-1687857","article-title":"Significant Adhesion Reduction with 4DryField PH after Release of Adhesive Small Bowel Obstruction","volume":"5","author":"Ahmad","year":"2019","journal-title":"Surg. J."},{"key":"ref_29","unstructured":"(2016). Biological Evaluation of Medical Devices\u2014Part 6: Tests for Local Effects After Implantation (Standard No. ISO 10993-6)."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jss.2008.08.008","article-title":"Choice of hemostatic agent influences adhesion formation in a rat cecal adhesion model","volume":"155","author":"Hoffmann","year":"2009","journal-title":"J. Surg. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e2405238","DOI":"10.1002\/adhm.202405238","article-title":"A Dual-Layer Hydrogel Barrier Integrating Bio-Adhesive and Anti-Adhesive Properties Prevents Postoperative Abdominal Adhesions","volume":"14","author":"Krishnan","year":"2025","journal-title":"Adv. Healthc. Mater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3847","DOI":"10.1021\/acsnano.2c12104","article-title":"Multifunctional Microgel-Based Cream Hydrogels for Postoperative Abdominal Adhesion Prevention","volume":"17","author":"Liu","year":"2023","journal-title":"ACS Nano"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1186\/s13256-016-1029-x","article-title":"Uterine perforation following a fractional curettage successfully treated with the modified polysaccharide 4DryField\u00ae PH: A case report","volume":"10","author":"Ziegler","year":"2016","journal-title":"J. Med. Case. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/13645706.2024.2351829","article-title":"4DryField vs. hyalobarrier gel for preventing the recurrence of intrauterine adhesions\u2014A pilot study","volume":"34","author":"Lisa","year":"2024","journal-title":"Minim. Invasive Ther. Allied Technol."}],"container-title":["Polymers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4360\/18\/1\/33\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:15:29Z","timestamp":1766499329000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4360\/18\/1\/33"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["polym18010033"],"URL":"https:\/\/doi.org\/10.3390\/polym18010033","relation":{},"ISSN":["2073-4360"],"issn-type":[{"type":"electronic","value":"2073-4360"}],"subject":[],"published":{"date-parts":[[2025,12,23]]}}}