Effects of pirfenidone and dermoid cyst fluid on adhesion formation

Abstract

Objective: To evaluate the effects of pirfenidone and human dermoid cyst fluid on adhesion formation in a rat model. Design: A prospective, blinded, controlled study. Setting: Sprague-Dawley white rats in a conventional laboratory setting. Intervention(s): Rats were divided into four groups according to the type of solution tested (dermoid fluid, 0.05 mg of pirfenidone, normal saline, and a combination of dermoid fluid and pirfenidone). In the first experiment, the solution (0.05 mL) was injected intraperitoneally. In the second experiment, the solution was instilled intraperitoneally after a standardized injury to the right uterine horn. The degree of adhesion formation was evaluated 2 weeks after the initial surgery. Result(s): Human dermoid cyst fluid caused adhesion in 4 of 10 intact rats and in 9 of 10 standardized injured rats. Pirfenidone did not decrease adhesion formation. No adhesion was found after injection of saline or pirfenidone in intact rats. The mean ± SEM adhesion score in standardized injured rats was higher in the dermoid group (4.6 ± 0.6) than in the pirfenidone group (2.8 ± 0.7) or the saline group (3.8 ± 0.5). The mean ± SEM adhesion score in intact rats was 0.6 ± 0.3 after dermoid fluid injection and after dermoid instillation in standardized injured rats was 4.6 ± 0.6. Conclusion(s): Human dermoid fluid causes adhesion formation even in intact rats, and the adhesion is worse in the presence of serosal injury. Intraperitoneal pirfenidone does not decrease adhesion formation.