The effectiveness of heparin, platelet-rich plasma (PRP), and silver nanoparticles on prevention of postoperative peritoneal adhesion formation in rats

Hamid Reza Makarchian,Pezhman Ghaderzadeh,Manoochehr Ghorbanpoor,Seyed Mohammad Reza Javadi,Amir Kasraianfard

doi:10.1590/s0102-865020170103

Hamid Reza Makarchian, Pezhman Ghaderzadeh + Show 3 more

Open Access

https://doi.org/10.1590/s0102-865020170103

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Abstract

To assess the effectiveness of heparin, platelet-rich plasma (PRP), and silver nanoparticles on prevention of postoperative adhesion in animal models. Sixty males Albino Wistar rats aged 5 to 6 weeks were classified into five groups receiving none, heparin, PRP, silver nanoparticles, PRP plus silver nanoparticles intraperitoneally. After 2 weeks, the animals underwent laparotomy and the damaged site was assessed for peritoneal adhesions severity. The mean severity scores were 2.5 ± 0.9, 2.16 ± 0.7, 1.5 ± 0.5, 2.66 ± 0.88, and 2.25 ± 0.62 in the control, heparin, PRP, silver and PRP plus silver groups, respectively with significant intergroup difference (p = 0.004). The highest effective material for preventing adhesion formation was PRP followed by heparin and PRP plus silver. Moreover, compared to the controls, only use of PRP was significantly effective, in terms of adhesion severity (p = 0.01) . Platelet-rich plasma alone may have the highest efficacy for preventing postoperative peritoneal adhesions in comparison with heparin, silver nanoparticles and PRP plus silver nanoparticles.

Highlights

The incidence of postoperative adhesions has been estimated at 67%-93% remained almost constant despite several attempts to prevent their formation[1]
After reaching the age of puberty and spending adaptation stage, the animals were classified to five subgroups including 1) deperitonalization at anterior wall of caecum without administration of any agent, 2) deperitonalization at anterior wall of caecum with administration of platelet-rich plasma (PRP) (PRP group), 3) deperitonalization at anterior wall of caecum with administration of silver nanoparticles, 4) deperitonalization at anterior wall of caecum with administration of PRP in combination with silver nanoparticles (PRP plus silver group), and 5) deperitonalization at anterior wall of caecum with administration of heparin
The highest effective material for preventing adhesion formation was PRP followed by heparin and PRP plus silver

Summary

Introduction

The incidence of postoperative adhesions has been estimated at 67%-93% remained almost constant despite several attempts to prevent their formation[1]. Patients are at risk of repetitive surgical interventions, which increases cost, morbidity, and mortality These complications may even lead to death, based on the reports by the National Hospital Discharge Survey, about approximately 2,000 people die every year in the United States from intestinal obstruction due to adhesions[3]. Several preventive methods and potential preventive agents have been studied, including lavage of abdominal cavity, lytic agents, macrophage promoting factors, nonsteroidal anti-nflammatory drugs, heparin, dextran 70, ringer lactate, antihistamine, prostaglandin synthesis inhibitors, calcium channel blockers, rofecoxib, and green tea extract[4,5,6,7,8] These agents may indirectly prevent the creation of adhesions by inhibiting inflammatory processes leading to adhesion formation, or may act as physical barriers in separating injured surfaces[9]

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