Abstract
Postoperative abdominal adhesions are one of the most common post-laparotomy complications observed. Several types of adhesion preventative agents are available and their effectiveness and adverse impact have been clinically evaluated in previous studies. However, few basic studies have tested whether those agents do not trigger any unwanted xenobiotic reaction, which makes some surgeons hesitant to use them. To clarify this point, we investigated whether the adhesion preventative agent Seprafilm® (KAKEN PHARMACEUTICAL CO., LTD., Tokyo, Japan), one of the most widely used hyaluronate-based bioresorbable membrane (HBBM), can trigger an inflammatory response in normal abdominal tissue and delay the healing process. The rat underwent laparotomy and a HBBM was placed directly below the incision. Tissue samples at the incision and away from the incision (normal tissue) were harvested and inflammatory response and fibrosis were evaluated using quantitative PCR and histological scoring. We found that HBBM did not induce inflammatory cytokine expression at mRNA level in the peritoneal wall tissue or modify the fibrosis process in the abdominal cavity. These findings confirm the safety of using HBBM for the prevention of adhesion development post-laparotomy.
Highlights
Postoperative abdominal adhesions are one of the most common complications observed post laparotomy
We investigated whether the adhesion preventative agent SeprafilmÒ (KAKEN PHARMACEUTICAL CO., LTD., Tokyo, Japan), one of the most widely used hyaluronatebased bioresorbable membrane (HBBM), can trigger an inflammatory response in normal abdominal tissue and delay the healing process
At day 7 post operation, the HBBMs implanted in Group IV rats were almost completely dissolved and absorbed; small segments were apparent on the liver surface of 2 cases
Summary
Postoperative abdominal adhesions are one of the most common complications observed post laparotomy (diZerega and Campeau 2001). A number of postsurgical adhesion preventative agents are available The efficacy of these agents has been evaluated in animal models (Bae et al 2005; Lim et al 2009; Ozcelik 2003; Harris et al 1995; Shimizu et al 2014; Oncel et al 2005), as well as several large scale human clinical studies (Becker et al 1996; Diamond 1996; Gonzalez-Quintero and Cruz-Pachano 2009). The safety of these agents is usually determined by monitoring the patients’ vital signs and laboratory tests, which enables the detection of a systemic reaction against the preventative agents. Xenobiotic reaction can happen locally (Bostman et al 1990; Bostman 1992), and the effect of
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