Evaluation of Surgical Anti-adhesion Products to Reduce Postsurgical Intra-abdominal Adhesion Formation in a Rat Model

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Feb 17

PMID 28207824

Citations 17

Authors

Long-Xiang Lin

Fang Yuan

Hui-Hui Zhang

Ni-Na Liao

Jing-Wan Luo

Yu-Long Sun

Affiliations

Soon will be listed here.

Abstract

Background: Adhesions frequently occur after abdominal surgery. Many anti-adhesion products have been used in clinic. However, the evidences are short for surgeons to reasonably choose the suitable anti-adhesion produces in clinical practice. This study provided such evidence by comparing the efficiency of five products to prevent abdominal adhesion formation in a rat model.

Methods: Fifty-six Sprague-Dawley rats were randomly divided into seven groups: sham-operation group, adhesion group, and five product groups (n = 8). The abdomens of rats were opened. The injuries were created on abdominal wall and cecum in the adhesion and product groups. The wounds on abdominal wall and cecum of rats in the adhesion group were not treated before the abdomens were closed. The wounds on abdominal wall and cecum of rats in the product groups were covered with anti-adhesion product: polylactic acid (PLA) film, Seprafilm®, medical polyethylene glycol berberine liquid (PEG), medical sodium hyaluronate gel (HA), or medical chitosan (Chitosan). Fourteen days after surgery, the adhesions were evaluated by incidence, severity, adhesion area on abdominal wall and adhesion breaking strength.

Results: The application of PLA film and Seprafilm® significantly reduced the incidence, severity, adhesion area and breaking strength of cecum-abdomen adhesion (P<0.05). HA, PEG and Chitosan failed to significantly reduce the cecum-abdomen adhesion (P>0.05). The statistical significances in the incidence and severity of abdomen-adipose adhesion between adhesion group and the product groups were not achieved. However, Seprafilm® was more effective to reduce abdomen-adipose adhesion than PLA film. Furthermore, it was found that the products tested in this study did not effectively reduce cecum-adipose adhesion. The application of PEG could result in abdomen-small intestine adhesion.

Conclusion: Based on the results of this study, the preference order of anti-adhesion products used to reduce postsurgical intra-abdominal adhesion formation is Seprafilm > PLA >> HA > Chitosan > PEG.

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References

Vlahos A, Yu P, Lucas C, Ledgerwood A . Effect of a composite membrane of chitosan and poloxamer gel on postoperative adhesive interactions. Am Surg. 2001; 67(1):15-21. View

Sun Y, Yang C, Amadio P, Zhao C, Zobitz M, An K . Reducing friction by chemically modifying the surface of extrasynovial tendon grafts. J Orthop Res. 2004; 22(5):984-9. DOI: 10.1016/j.orthres.2004.02.005. View

Ersoy E, Ozturk V, Yazgan A, Ozdogan M, Gundogdu H . Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats. J Gastrointest Surg. 2008; 13(2):282-6. DOI: 10.1007/s11605-008-0678-5. View

Arung W, Drion P, Cheramy J, Honore P, Meurisse M, Defraigne J . Intraperitoneal adhesions after open or laparoscopic abdominal procedure: an experimental study in the rat. J Laparoendosc Adv Surg Tech A. 2012; 22(7):651-7. DOI: 10.1089/lap.2012.0102. View

Mettler L, Hucke J, Bojahr B, Tinneberg H, Leyland N, Avelar R . A safety and efficacy study of a resorbable hydrogel for reduction of post-operative adhesions following myomectomy. Hum Reprod. 2008; 23(5):1093-100. DOI: 10.1093/humrep/den080. View

Harris E, MORGAN R, Rodeheaver G . Analysis of the kinetics of peritoneal adhesion formation in the rat and evaluation of potential antiadhesive agents. Surgery. 1995; 117(6):663-9. DOI: 10.1016/s0039-6060(95)80010-7. View

Liu M, Li P . [Clinical value of anti-adhesion agents used in laparotomy in obstetrics and gynecology]. Zhonghua Fu Chan Ke Za Zhi. 2012; 47(4):255-8. View

Alponat A, Lakshminarasappa S, Yavuz N, Goh P . Prevention of adhesions by Seprafilm, an absorbable adhesion barrier: an incisional hernia model in rats. Am Surg. 1997; 63(9):818-9. View

Ward B, Panitch A . Abdominal adhesions: current and novel therapies. J Surg Res. 2009; 165(1):91-111. DOI: 10.1016/j.jss.2009.09.015. View

10.

Mais V, Bracco G, Litta P, Gargiulo T, Melis G . Reduction of postoperative adhesions with an auto-crosslinked hyaluronan gel in gynaecological laparoscopic surgery: a blinded, controlled, randomized, multicentre study. Hum Reprod. 2006; 21(5):1248-54. DOI: 10.1093/humrep/dei488. View

11.

Arung W, Meurisse M, Detry O . Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011; 17(41):4545-53. PMC: 3225091. DOI: 10.3748/wjg.v17.i41.4545. View

12.

Yuan F, Lin L, Zhang H, Huang D, Sun Y . Effect of carbodiimide-derivatized hyaluronic acid gelatin on preventing postsurgical intra-abdominal adhesion formation and promoting healing in a rat model. J Biomed Mater Res A. 2016; 104(5):1175-81. DOI: 10.1002/jbm.a.35653. View

13.

Ellis H . The causes and prevention of intestinal adhesions. Br J Surg. 1982; 69(5):241-3. DOI: 10.1002/bjs.1800690502. View

14.

Mettler L, Audebert A, Lehmann-Willenbrock E, Schive K, Jacobs V . Prospective clinical trial of SprayGel as a barrier to adhesion formation: an interim analysis. J Am Assoc Gynecol Laparosc. 2003; 10(3):339-44. DOI: 10.1016/s1074-3804(05)60258-7. View

15.

Menzies D, Ellis H . Intestinal obstruction from adhesions--how big is the problem?. Ann R Coll Surg Engl. 1990; 72(1):60-3. PMC: 2499092. View

16.

van Goor H . Consequences and complications of peritoneal adhesions. Colorectal Dis. 2007; 9 Suppl 2:25-34. DOI: 10.1111/j.1463-1318.2007.01358.x. View

17.

Ouaissi M, Gaujoux S, Veyrie N, Deneve E, Brigand C, Castel B . Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature. J Visc Surg. 2012; 149(2):e104-14. DOI: 10.1016/j.jviscsurg.2011.11.006. View