Methods and compositions for reducing or eliminating post-surgical adhesion formation

Abstract

The present invention relates to a method for reducing adhesions associated with post-operative surgery. The present method comprises administering or affixing a polymeric composition preferably comprising chain extended, coupled or crosslinked polyester/poly(oxyalkylene) ABA triblocks or AB diblocks having favorable EO/LA ratios to a site in the body which has been subjected to trauma, e.g. by surgery, excision or inflammatory disease. In the present invention, the polymeric material provides a barrier to prevent or reduce the extent of adhesions forming.

1 - 92 . (canceled)  
   
   
       93 . A composition for use in reducing or preventing adhesions in a patient comprising a polymer of the chemical structure:  
     
       
         
         
             
             
         
       
     
     Where m and k are positive integers, 
 R is an ethylene or propylene group with the proviso that R is not exclusively ethylene where R′ contains an absence of poly(ethylene oxide), R′ is a C 2  to C 12  alkylene group, a cycloalkyl or cycloalkyl-containing group, an aryl or aryl-containing group, 4,4′-diphenylmethane, toluene, naphthalene, 4,4′-dicyclohexylmethane, cyclohexyl, 3,3′-dimethylphenyl, 3,3′-dimethyl-diphenylmethane, 4,6′-xylylene, 3,5,5-trimethylcyclohexyl, 2,2,4-trimethylhexamethylene, p-phanylene or a poly(ethylene oxide) containing or poly(ethylene oxide) rich chain and K is any group derived from a compound which is unable to initiate ring opening polymerization of a starting lactone, said polymeric composition having an EO/LA ratio which falls within the range of about 0.1 to about 100.  
 
   
   
       94 . The composition according to claim  83  wherein K is a C 1  to C 12  alkyl group, an aryl group, an aralkyl group or a substituted C1 to C12 alkyl group, an aryl group, an aralkyl group, a C═C-containing group.  
   
   
       95 . The composition according to claim  83  where K is methyl or ethyl.  
   
   
       96 . A composition for use in reducing or preventing adhesions in a patient comprising a polymer of the chemical structure:  
     
       
         
         
             
             
         
       
     
     where m and x are positive integers, 
 R is an ethylene or propylene group with the proviso that R is not exclusively a propylene group when R″ and R′″ contain an absence of poly(ethylene oxide) , R1 is a hydrogen or methyl group, R″ is a C 0  to C 12  alkylene group or a hydroxyl or carboxylic acid substituted alkyl group, a cycloalkyl, a hydroxyl-containing cycloalkyl, or cycloalkyl-containing group, an aryl or aryl-containing group, or a polyoxyalkylene chain-containing group comprised of poly(ethylene oxide), poly(ethylene oxide)-co-poly(propylene oxide) or a poly(ethylene oxide) rich chain, R′″ is selected from the group consisting of poly(ethylene oxide), poly(ethylene oxide)-co-poly(propylene oxide), a poly(ethylene oxide)-rich chain, a diol, a diamine, a dicarboxylic acid and an ABA triblock, wherein A is a polyester unit and B is selected from the group consisting of poly(ethylene oxide), poly(ethylene oxide)-co-poly(propylene oxide) , a poly(ethylene oxide)-rich chain, a diol, a diamine, and a dicarboxylic acid, R 1  is H or CH 3  and M is a non-reactive group, said polymeric composition having an EO/LA ratio which falls within the range of about 0.1 to about 100.  
 
   
   
       97 . The method according to claim  86  wherein said diol is selected from the group consisting of ethylene glycol, butanediol, (H-terminated polycaprolactone, poly(propylene glycol), (H-terminated polyester or oligoesters, tartaric acid, said diamine is selected from the group consisting of ethylene diamine, hexamethylene diamine, amino acids, and oligopeptides and said dicarboxylic acid is delected from the group consisting of succinic acid, sebacic acid, adipic acid, malic acid, oxalic acid, maleic acid, fumaric acid, COOH-terminated polycaprolactone, and COOH-terminated polyesters or oligoesters.  
   
   
       98 . The composition according to claim  86  wherein said non-reactive group is a C 1  to C 12  alkyl group, an aryl group, an aralkyl group or a substituted C 1  to C 12  alkyl group, an aryl group, an aralkyl group or a blocking group.  
   
   
       99 . The composition according to claim  86  where M is methyl or ethyl.  
   
   
       100 . A composition for use in reducing or preventing adhesions in a patient comprising a polymer of the chemical structure:  
     
       
         
         
             
             
         
       
     
     where m and a are positive integers, 
 R is an ethylene group and/or propylene group with the proviso that R is not exclusively a propylene group when R′ contains an absence of poly(ethylene oxide), M is a non-reactive group, R′ is a C 2  to C 12  alkylene group, a cycloalkyl or cycloalkyl-containing group, an aryl or arly-containing group, 4,4′-diphenylmethane, toluene, naphthalene, 4,4′-dicyclohexylmethane, cyclohexyl, 3,3′dimethylphenyl, 3,3′-dimethyl-diphenylmethane, 4,6′-xylylene, 3,5,5-trimethylcyclohexyl, 2,2,4-trimethylhexamethylene, p-phenylene or a poly(ethylene oxide) containing or poly(ethylene oxide) rich chain, M is a non-reactive group, R 1  is H or CH 3  said polymeric composition having an EO/LA ration which falls within the range of about 0.1 to about 100.  
 
   
   
       101 . The composition according to claim  90  wherein said non-reactive group is a C 1  to C 12  alkyl group, an aryl group, an aralkyl group or a substituted C 1  to C 12  alkyl group, an aryl group, an aralkyl group or a blocking group.  
   
   
       102 . The composition according to claim  91  where M is methyl or ethyl.