Abstract
We aimed to evaluate the effects of the barrier agent sodium carboxymethyl cellulose (SCMC) with and without dexamethasone for the prevention of postoperative adhesion formation in a rat model of postoperative peritoneal adhesion. A total of 160 three-month old male and female Wistar rats underwent a laparotomy, and adhesions were induced by ileocecal abrasion. Rats were randomly assigned to 4 groups (n=40 each): group A, untreated; group B, treated with SCMC only; group C1, treated with SCMC + 3 mg dexamethasone, and group C2, treated with SCMC + 8 mg dexamethasone. After 12 days, adhesion formation and histopathological changes were compared. In groups A, B, C1, and C2, the mortality rates were 10, 5, 5, and 5%, respectively. In groups C1 and C2, the adhesions were filmy and easy to dissect and were milder compared with those in groups A and B. The total adhesion score in group C1 (3.38±0.49) was significantly lower than that of group B (6.01±0.57; P<0.01) or group A (8.01±0.67; P<0.05). There was no significant difference in adhesion formation between groups C1 and C2. Compared with groups A and B, groups C1 and C2 exhibited milder histopathological changes. SCMC in combination with dexamethasone can prevent adhesion formation and is a better barrier agent than SCMC alone. The safety and feasibility of SCMC in combination with dexamethasone to prevent adhesion formation after abdominal surgery warrants further clinical study.
Highlights
Peritoneal adhesions, or bands of fibrous tissue connecting abdominal organs, are clinical complications caused by a wide variety of diseases and disorders
We aimed to evaluate the effects of the barrier agent sodium carboxymethyl cellulose (SCMC) with and without dexamethasone for the prevention of postoperative adhesion formation in a rat model of postoperative peritoneal adhesion
Autopsies showed that 3 rats in group A and 2 rats in group B died of strangulation necrosis induced by severe bowel adhesions
Summary
Peritoneal adhesions, or bands of fibrous tissue connecting abdominal organs, are clinical complications caused by a wide variety of diseases and disorders. Attempts at preventing adhesions have included improving surgical techniques [3]; reducing serosal injury; using anticoagulants such as heparin to prevent fibrin deposition [4,5], hyaluronidase and streptokinase to remove fibrin exudation [6], or dexamethasone to inhibit fibroblastic growth; and applying sodium carboxymethyl cellulose (SCMC) [7]. None of these methods effectively prevent peritoneal adhesions under all surgical conditions, and the incidence of postoperative abdominal adhesions is still very high [2]. Local application of barrier agents such as SCMC has been shown to reduce the formation of adhesions in rats and humans, and it has been approved for clinical use [14,15]
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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