(12) Patent Application Publication (10) Pub. No.: US 2011/0052712 A1 Eaton Et Al
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US 2011 0052712A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2011/0052712 A1 Eaton et al. (43) Pub. Date: Mar. 3, 2011 (54) SPRAYABLE POLYMERS ASADHESION Publication Classification BARRIERS (51) Int. Cl. A6II 3/765 (2006.01) (76) Inventors: Donald J. Eaton, Los Altos, CA A6IR 9/14 (2006.01) (US); Bin Huang, Pleasanton, CA A6IP4/00 (2006.01) (US); Michael A. Savitt, River (52) U.S. Cl. ......... 424/493; 424/497; 424/499: 424/501; Hills, WI (US) 424/78.31; 424/78.37; 514/60: 514/53 (57) ABSTRACT A formulation for generating an adhesion barrier that (21) Appl. No.: 12/705,436 includes a plurality of particles or a dry powder that is made of a polymer combination of at least one biodegradable poly (22) Filed: Feb. 12, 2010 mer and at least one water Soluble polymer is disclosed. Methods of making and delivering the formulation are further disclosed. The formulation of particles is deposited on a sur Related U.S. Application Data face of internal body tissue and the deposited formulation absorbs moisture from the tissue and forms a film over the (60) Provisional application No. 61/237,669, filed on Aug. Surface. The film acts as an adhesion barrier by reducing or 27, 2009. preventing adhesion of the Surface to other body tissue. Patent Application Publication Mar. 3, 2011 Sheet 1 of 10 US 2011/0052712 A1 F.G. 1B ***3. FIG. 2 Patent Application Publication Mar. 3, 2011 Sheet 2 of 10 US 2011/0052712 A1 Step 1 Biodegradable polymer or polymers is dissolved into an organic or inorganic Solvent. Step 2 Solution is sprayed and dried to produce particles of the biodegradable polymer. Step 3 Particles of biodegradable polymer are blended with particles of water Soluble polymer to produce a biodegradable and water Soluble particle mixture. FIG. 3 Step 1 Prepare two separate polymer Solutions: one Solution is a biodegradable polymer dissolved in a first Solvent and other Solution is a water Soluble polymer dissolved in a Second Solvent Step 2 Two Solutions are mixed to form an emulsion containing two liquid phases. Step 3 Spray dry emulsion to form particles FIG. 4 Patent Application Publication Mar. 3, 2011 Sheet 3 of 10 US 2011/0052712 A1 FIG. 5A Patent Application Publication Mar. 3, 2011 Sheet 4 of 10 US 2011/0052712 A1 FIG. 6A F.G. 6B Patent Application Publication Mar. 3, 2011 Sheet 5 of 10 US 2011/0052712 A1 8. FIG. 8 Patent Application Publication Mar. 3, 2011 Sheet 7 of 10 US 2011/0052712 A1 Patent Application Publication Mar. 3, 2011 Sheet 8 of 10 US 2011/0052712 A1 F.G. 13 Patent Application Publication Mar. 3, 2011 Sheet 9 of 10 US 2011/0052712 A1 F.G. 14 Patent Application Publication Mar. 3, 2011 Sheet 10 of 10 US 2011/0052712 A1 FIG. 16 US 2011/0052712 A1 Mar. 3, 2011 SPRAYABLE POLYMERS ASADHESION configurations of the human body, and often difficult to place BARRIERS in hard to reach areas within the Surgical field. 0007. Several liquid solutions have also been marketed as CROSS REFERENCE TO RELATED adhesion prevention systems. Adept(R), developed by Baxter, APPLICATION for example and Resolve(R), developed by Synthemed, are 0001. This application claims benefit of and incorporates liquids that can be introduced directly to the intraperitoneal by reference U.S. Patent Application No. 61/237,669 which cavity. Specifically, they are used as an instillate after the was filed on Aug. 27, 2009. surgery, and the entire site is washed with the solution. How ever, since these products are liquid, they do not remain at the FIELD OF THE INVENTION Surgical site for very long past their introduction into and 0002 This invention relates generally to adhesion barriers around the Surgical site. As mentioned earlier, it is highly and in particular to sprayable and biodegradable polymer desirable for the material to be present and provide the barrier adhesion barriers for prevention of post-operative Surgical function for a pre-determined time period, which could be adhesion formation. many weeks. 0008 Gel-based adhesion barriers have been developed to DESCRIPTION OF THE RELATED ART overcome the shortcomings discussed above. SprayGel(R) by 0003 Post-operative surgical adhesions are a normal part Confluent, for example, is a spray composed of two polymers of the Surgical healing processes. Many adhesions are that combine upon spraying to create a film on the Surgical desired, and are an integral and important part of the healing site. Confluent Surgical markets a similar product, whereby of the surgical field. However, adhesions can also result in two liquids are combined prior to application to the Surgical unwanted scar tissue between vital structures in the body and site. can result in significant post-operative Surgical problems or 0009. An additional short-coming of the products men morbidity. Such adhesions can significantly impact an indi tioned above is their early absorption within the surgical field. vidual's health, well-being and quality of life. The formation It is desirable to have the adhesion barrier absorb over time, of post-operative Surgical adhesions in the abdomen can lead after fibrin and collagen have been formed to prevent adhe to chronic pain, infertility, and small bowel obstruction sion. This generally takes between 30-60 days and could be (SBO). Adhesions after thoracic and cardiac Surgeries can lead to serious consequences during Subsequent re-operative longer in patients with impaired wound healing. The current cardiothoracic procedures. gel-based absorbable products are generally absorbed within 0004. The incidence of adhesions forming after surgical one week, and thus only prevent adhesions in the early phase procedures is 100%, with less than 5% of adhesions being of healing. Thus, some adhesion still occurs after the product caused by inflammation. Adhesions form after all types of has been fully absorbed. The adhesion barrier film Cardio Surgeries (abdominal, pelvic, cardiac, thoracic, spinal, plas wrap is present up to 60 days, but has the shortcomings of the tic, hand, and knee). In the USA, the cost of abdominal and film-based barrier discussed above. pelvic adhesions to the healthcare system in 1998 was esti 0010. Another shortcoming of the mentioned products is mated at S1.6 billion based on 5.6 million surgical procedures the effectiveness of the particles in forming a cohesive film deemed “at risk” for developing postoperative related surgi that can resist or prevent tissue growth or penetration through cal complications. these barriers. The use of overlapping biodegradable particles 0005 Post-operative adhesions are a common, expensive that are capable of forming an effective barrier has thus far problem for patients and the healthcare system. Various been ignored. approaches have been considered to reduce or eliminate post Surgical adhesions. Such approaches include minimizing 0011 Ke and Sun describe blends of poly(vinyl alcohol) trauma to the tissue and tissue exposure to foreign body, and with poly(L-lactide) which have a higher water absorption placing physical barriers between injured tissue. It has been than poly(L-lactide) alone. (Starch, Poly(lactic acid) and Poly Suggested that separating the raw to prevent tissue surfaces (vinyl alcohol) Blends, Journal of Polymers and the Environ from coming into contact with each other during the healing ment, Vol. 11, No. 1 (January 2003) They also show that process significantly minimizes adhesion formation. As the blends of starch/poly(vinyl alcohol)/poly(L-lactide) have healing process takes weeks to months, it will be ideal to keep improved compatibility and mechanical properties over a the Surfaces apart, at their natural locations, without coming starch/poly(L-lactide) blend. into contact with each other during the period of healing. 0012 Despite advances in the field, additional improve Physical barriers are helpful in this regard as long as they can ments are desirable. In particular, it would be advantageous to be biocompatible and preferably biodegradable. Addition provide an adhesion barrier that is deliverable as an aerosol or ally, any such barrier should be easy to use and fit in with by brushing. This will allow direct and exact application to commonly used Surgical procedures and protocols. the desired sites, with minimal or no application to areas 0006. In the case of physical barriers, one of the more where adhesion is desired. Such a product would have the traditional methods involves placing a thin polymer-based advantages of being easier to store than a liquid or gel, while film at the Surgical site, usually upon the completion of the having greater contact with the desired treatment site than a Surgery. Such a method is presently marketed by Genzyme liquid. It will be manufactured to provide prolonged barrier Biosurgery (SeprafilmR) and Cryolife (CardioWrap(R). protection. It may effectively use particles that are capable of Limitations of such a method, however, are that the film must overlapping while forming an effective barrier. It may also be cut to correspond to the desired site which adds time to contain therapeutic agents to allow for delivery over time to a Surgery, the membranes are uniform and cumbersome to specific area of the surgical field. Such an adhesion barrier work with, difficult to configure to the infinite geometric would be simultaneously easy to use, efficacious and cost US 2011/0052712 A1 Mar. 3, 2011 effective. At least some of these objectives will be met by the 0023 FIG. 5A depicts an overhead view of an adhesion inventions described hereinafter. barrier film over a selected area of surface region of tissue. 0024 FIG. 5B depicts a cross-sectional view of the film of SUMMARY OF THE INVENTION FIG.S.A.