Abstract
To investigate the potential efficacy of beractant (Survanta(r)) and Seprafilm(r) on the prevention of postoperative adhesions. Forty Wistar-albino female rats were used. The rats were randomly allocated into four groups of 10 rats each as control group (CG), beractant group (BG), Seprafilm(r) group (SG), and combined group (COG). All rats underwent cecal abrasion via midline laparotomy. Before abdominal closure, isotonic saline, beractant, Seprafilm, and combined agents were intraperitoneally administered. Adhesions were classified macroscopically with Canbaz Scoring System on postoperative day 10. Ceacum was resected for histopathological assessment. Macroscopic adhesion scores were significantly lower in BG, SG, and COG than CG (p<0.05); (45%, 15%, 25%, and 15%; respectively). Histopathological assessment revealed a reduced inflammation and fibrosis score in the study groups than CG (p<0.05). In BG, adhesion development, inflammation and fibrosis scores were lower than SG; however, it was not statistically significant. Intra-abdominal application of beractant is significantly effective for the prevention of adhesion formation with no adverse effect by covering the whole peritoneal mesothelium with excellent gliding properties in a rat model. The combination of both agents is also effective in reducing adhesion formation, however, not superior to single beractant application.
Highlights
Postoperative adhesions (PA) still remain a major surgical problem that should be solved after abdominal surgery even though we are in modern surgical era
Macroscopic adhesion rates were significantly lower in group 2, 3, and 4 with a rate of 30%, 50%, and %30; respectively when compared with control group (90%) (p
Seprafilm application significantly reduced adhesion scores comparing with the control group (p
Summary
Postoperative adhesions (PA) still remain a major surgical problem that should be solved after abdominal surgery even though we are in modern surgical era. Intra-abdominal adhesions may cause chronic abdominal pain, intestinal obstruction, feeding intolerance, and infertility[1,2,3,4,5,6]. 3-8% of these patients may undergo redo surgeries mainly for acute intestinal obstruction[6]. Bowel injuries while re-entering the abdominal cavity due to dense adhesions is the main complication of redo surgery[2]. This fact leads to high morbidity and mortality. For this reason, prevention of postoperative adhesion formation is still a popular topic among the investigators
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