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Abstract
BackgroundAdhesions are a common postoperative surgical complication. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions. However, solid barriers are considered more effective than liquids in decreasing postoperative intra-abdominal adhesion formation; therefore, a new pectin-honey hydrogel (PHH) was produced and its effectiveness was evaluated in a rat cecal abrasion model.Standardized cecal/peritoneal abrasion was performed through laparotomy in 48 adult Sprague-Dawley rats to induce peritoneal adhesion formation. Rats were randomly assigned to a control (C) and treatment (T) group. In group T, PHHs were placed between the injured peritoneum and cecum. Animals were euthanized on day 15 after surgery. Adhesions were evaluated macroscopically and adhesion scores were recorded and compared between the two groups. Inflammation, fibrosis, and neovascularization were histologically graded and compared between the groups.ResultsIn group C, 17 of 24 (70.8%) animals developed adhesions between the cecum and peritoneum, while in group T only 5 of 24 (20.8%) did (p = 0.0012). In group C, one rat had an adhesion score of 3, sixteen had scores of 2, and seven rats had scores of 0. In group T, four rats had adhesion scores of 2, one rat had an adhesion score of 1 and nineteen have score 0 (p = 0.0003). Significantly lower grades of inflammation, fibrosis, and neovascularization were seen in group T (p = 0.006, p = 0.001, p = 0.002, respectively).ConclusionPHH is a novel absorbable barrier that is effective in preventing intra-abdominal adhesions in a cecal abrasion model in rats.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-0965-z) contains supplementary material, which is available to authorized users.
Highlights
Adhesions are a common postoperative surgical complication
Because honey has proven effective in preventing intra-abdominal adhesions in liquid form, and since anti-adhesion barriers may be more effective than intraperitoneal solutions, we developed honey-based films that could be used as physical anti-adhesion barriers
Presence of adhesions In group C, 17 of 24 (70.8%) animals developed adhesions between the cecum and the peritoneum, while in group T only 5 of 24 (20,8%) did (p = 0.0012) (Table 1)
Summary
Adhesions are a common postoperative surgical complication. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions. Solid barriers are considered more effective than liquids in decreasing postoperative intra-abdominal adhesion formation; a new pectin-honey hydrogel (PHH) was produced and its effectiveness was evaluated in a rat cecal abrasion model. Postoperative intra-abdominal adhesion formation has long been considered an inevitable consequence of laparotomy, and the incidence in abdominal surgery is ranging between 67 and 93% [1–4]. Physical barriers are considered the most effective treatments for preventing postoperative intra-abdominal adhesion formation [10]. There are various types of commercially available anti-adhesion barriers such as hyaluronic acid/carboxymethyl cellulose membranes and hyaluronic acid/carboxymethyl cellulose gels. There are various types of commercially available anti-adhesion barriers such as hyaluronic acid/carboxymethyl cellulose membranes and hyaluronic acid/carboxymethyl cellulose gels2 These membranes work by preventing contact between damaged surfaces [3, 5, 10, 11]
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