Abstract
In previous studies, N,O-carboxymethyl chitosan has been shown to decrease the incidence and intensity of abdominal adhesions. In the present study, adhesions were induced in 220 rabbits using a double uterine horn model. Rabbits were randomized to receive an operation only or an operation+medical chitosan intraperitoneally. Twenty-two rabbits from each group were euthanized at one of five different times (Day 3, 7, 14, 28, or 42), and adhesion formation was given gross and histopathological scores. Reductions were observed in adhesion extent (P=0.0337) and tenacity (P=0.0271) as well as inflammation (P<0.0001) on Day 3 when medical chitosan was applied. Prior to Day 14, fibrosis was less obvious in the medical chitosan group (P< 0.0005). The tenacity scores were significantly lower in the medical chitosan group following Day 14 (P<.05), while the type scores were lower in the medical chitosan group following Day 28 (P<.03). Thus, medical chitosan decreased both the gross and the histopathological scores of the induced adhesions.
Highlights
Peritoneal adhesions are primarily induced by surgical procedures in the peritoneal cavity
No NOCC residue was evident around the wounds, and adhesions in the NOCC group were relatively looser
We performed the present study to investigate the effects of NOCC application in both situations
Summary
Peritoneal adhesions are primarily induced by surgical procedures in the peritoneal cavity. Despite advances in surgical techniques in recent years, the incidence of postoperative adhesions is still as high as 94% in patients undergoing abdominopelvic operations, even with meticulous operative techniques (Stanciu and Menzies, 2007; Liakakos et al, 2001). Adhesions remain a major source of morbidity and mortality and a substantial financial burden (Wiseman, 2008). Many adhesion-related complications necessitate additional corrective surgeries. Additional surgeries can exacerbate adhesions and lead to additional and more severe complications (Tittel et al, 2001). The pathogenesis of intra-abdominal adhesions has not been entirely delineated. Several therapeutic strategies have been used to prevent adhesion formation, including surgical techniques. Areview of 27 studies investigating the relationship between various surgical techniques and adhesion-related consequences re-
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