Intraperitoneal Adhesion Formation Research Articles

HuoXueTongFu formula induces M2c macrophages via the MerTK/PI3K/AKT pathway to eliminate NETs in intraperitoneal adhesion in mice

Ethnopharmacological relevanceHuoXueTongFu Formula (HXTF) is a traditional Chinese herbal formula that has been used as a supplement and alternative therapy for intraperitoneal adhesion (IA). However, its specific mechanism of action has not been fully understood. Aim of the studyIn surgery, IA presents an inevitable challenge, significantly impacting patients' physical and mental well-being and increasing the financial burden. Our previous research has confirmed the preventive effects of HXTF on IA formation. However, the precise mechanism of its action still needs to be understood. MethodsIn this study, the IA model was successfully established by using the Ischemic buttons and treated with HXTF for one week with or without Mer Tyrosine Kinase (MerTK) inhibitor. We evaluated the pharmacodynamic effect of HXTF on IA mice. The MerTK/phosphoinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway-associated proteins were detected by Western blotting. Neutrophil extracellular traps (NETs) were detected by immunofluorescence. Macrophage phenotype was assessed by immunohistochemistry and flow cytometry. Inflammatory cytokines were detected by Real Time Quantitative PCR and Western blotting. ResultsHXTF reduced inflammatory response and alleviated IA. HXTF significantly enhanced MerTK expression, increased the number of M2c macrophages, and decreased the formation of NETs. In addition, the MerTK/PI3K/AKT pathway was significantly activated by HXTF. However, after using MerTK inhibitors, the role of HXTF in inducing M2c macrophage through activation of the PI3K/AKT pathway was suppressed and there was no inhibitory effect on NETs formation and inflammatory responses, resulting in diminished inhibition of adhesion. ConclusionHXTF may improve IA by activating the MerTK/PI3K/AKT pathway to induce M2c polarization, which removes excess NETs and attenuates the inflammatory response.

Postoperative Peritoneal Granulomatous Inflammation After the Application of Potato Starch-Based Anti-Adhesive Agent in Laparoscopic Endometriosis Surgery.

Endometriosis is a chronic inflammatory oestrogen-dependent disease. It is characterised by elevated inflammatory markers in the peritoneal milieu with subsequent adhesiogenesis. Nowadays, excisional, and ablative surgeries are considered the main treatment of endometriosis, and adhesiolysis is being performed almost routinely during these procedures. Postoperative adhesion formation is a significant concern for many surgeons, especially as endometriosis patients are assumed to be predisposed to adhesiogenesis. In order to minimise adhesiogenesis after endometriosis surgery, the usage of different barrier methods have been discussed in the literature. Recent studies aim to investigate the effect of potato starch preparations on adhesion formation in endometriosis patients. We aim to describe the findings of a second-look laparoscopy on patients who received a starch-based anti-adhesive agent. We present a retrospective case series that included the medical, surgical, and histopathologic data of three patients. Intraperitoneal adhesion formation and peritoneal inflammation. All three patients had de-novo adhesions during the second-look laparoscopy. Pathological examination revealed noncaseating granulomatosis of the peritoneum in all patients. The use of potato starch-based agents as a peritoneal adhesion prophylaxis in laparoscopic endometriosis surgery could lead to granulomatous peritoneal inflammation. Correct application by avoiding powder remnants through complete rinsing and transformation to gel seems to be an important factor to avoid this adverse effect. We aim to highlight that potato starch-based anti-adhesive agents similar to the one used in this study could be a cause of adhesiogenesis and peritoneal inflammation.

Polyvinylpyrrolidone-Alginate Film Barriers for Abdominal Surgery: Anti-Adhesion Effect in Murine Model.

Surgical operations on the peritoneum are often associated with the formation of adhesions, which can interfere with the normal functioning of the internal organs. The effectiveness of existing barrier materials is relatively low. In this work, the effectiveness of soluble alginate-polyvinylpyrrolidone (PVP-Alg) and non-soluble Ca ion cross-linked (PVP-Alg-Ca) films in preventing these adhesions was evaluated. Experiments in vivo were performed on mice via mechanical injury to the adjacent peritoneum wall and the caecum, followed by the application of PVP-Alg or PVP-Alg-Ca films to the injured area. After 7 days, samples from the peritoneal wall and caecum were analyzed using histology and quantitative polymerase chain reaction (qPCR). It was shown that the expression of genes responsible for adhesion formation in the caecum in the PVP-Alg group was comparable to that in the control group, while in the PVP-Alg-Ca group, it increased by 5-10 times. These results were consistent with the histology: in the PVP-Alg group, the adhesions did not form, while in the PVP-Alg-Ca group, the adhesions corresponded to five points on the adhesion scale. Therefore, the formation of intraperitoneal adhesions can be effectively prevented by non-crosslinked, biodegradable PVP-Alg films, whereas cross-linked, not biodegradable PVP-Alg-Ca films cause inflammation and adhesion formation.

Peritoneal lavage with Glycyrrhiza glabra is effective in preventing peritoneal adhesion in a rat model.

Intraperitoneal adhesion formation is a significant problem following surgeries, resulting in substantial clinical and economic consequences. Glycyrrhiza glabra has several pharmacological properties consisting of anti-inflammatory, anti-microbial, anti-oxidant, anti-cancer, and immunomodulatory activities. Therefore, we aimed to investigate the impacts of G. glabra on the development of post-operative abdominal adhesion in a rat model. Male Wistar rats weighing 200-250g were divided into six groups (n = 8): Group 1: normal group (non-surgical), and the surgical groups including Group 2: control group received the vehicle, Group 3: G. glabra 0.5% w/v, Group 4: G. glabra 1% w/v, Group 5: G. glabra 2% w/v, and Group 6: dexamethasone, 0.4% w/v. The intra-abdominal adhesion was performed utilizing soft sterilized sandpaper on one side of the cecum, and the peritoneum was slightly washed with 2ml of the extract or vehicle. In addition, macroscopic examination of adhesion scoring and the levels of inflammatory mediators [interferon (IFN)-γ, prostaglandin E2 (PGE2)], fibrosis markers [interleukin (IL)-4, transforming growth factor (TGF)-ꞵ], and oxidative factors [malondialdehyde (MDA), nitric oxide metabolites (NO), and reduced glutathione (GSH)] were evaluated. In vitro toxicities were also done on mouse fibroblast L929 and NIH/3T3 cell lines. We found higher levels of adhesion (P < 0.001), IFN-γ(P < 0.001), PGE2(P < 0.001), IL-4(P < 0.001), TGF-β(P < 0.001), MDA(P < 0.001), and NO(P < 0.001), and lower levels of GSH(P < 0.001) in the control group. In contrast, G. glabra concentration dependent and dexamethasone alleviated the levels of adhesion (P < 0.05), inflammatory mediators (P < 0.001-0.05), fibrosis (P < 0.001-0.05), and oxidative (P < 0.001-0.05) factors, while propagating the anti-oxidant marker (P < 0.001-0.05) in comparison to the control group. Results also showed that the extract did not significantly reduce cell viability up to 300µg/ml (P > 0.05). G. glabra could concentration-dependently mitigate peritoneal adhesion formation through its anti-inflammatory, anti-fibrosis, and anti-oxidant properties. However, further clinical investigations are required to approve that G. glabra may be a promising candidate against post-surgical adhesive complications.

Ultra-Fine Polyethylene Hernia Meshes Improve Biocompatibility and Reduce Intraperitoneal Adhesions in IPOM Position in Animal Models.

(1) Introduction: The intraperitoneal onlay mesh technique (IPOM) is widely used to repair incisional hernias. This method has advantages but suffers from complications due to intraperitoneal adhesion formation between the mesh and intestine. An ideal mesh minimizes adhesions and shows good biocompatibility. To address this, newly developed multifilamentous polyethylene (PET) meshes were constructed from sub-macrophage-sized monofilaments and studied regarding biocompatibility and adhesion formation. (2) Methods: We investigated fine (FPET, 72 filaments, 11 µm diameter each) and ultra-fine multifilament (UFPET, 700 filaments, 3 µm diameter each) polyethylene meshes for biocompatibility in subcutaneous implantation in rats. Adhesion formation was analyzed in the IPOM position in rabbits. Geometrically identical mono-filamentous polypropylene (PP) Bard Soft® PP meshes were used for comparison. Histologic and immune-histologic foreign body reactions were assessed in 48 rats after 7 or 21 days (four mesh types, with two different mesh types per rat; n = 6 per mesh type). Additionally, two different mesh types each were placed in the IPOM position in 24 rabbits to compile the Diamond peritoneal adhesion score after the same timeframes. The biocompatibility and adhesion score differences were analyzed with the Kruskal–Wallis nonparametric statistical test. (3) Results: Overall, FPET and, especially, UFPET showed significantly smaller foreign body granulomas compared to PP meshes. Longer observation periods enhanced the differences. Immunohistology showed no significant differences in the cellular immune response and proliferation. UFPET demonstrated significantly reduced peritoneal adhesion formation compared to all other tested meshes after 21 days. (4) Conclusions: Overall, FPET and, especially, UFPET demonstrated their suitability for IPOM hernia meshes in animal models by improving major aspects of the foreign body reaction and reducing adhesion formation.

The Inhibitory Effects of Naringin in a Rat Model of Postoperative Intraperitoneal Adhesion Formation.

Background Many attempts have been made to inhibit the formation of postoperative intraperitoneal adhesions, but the results have been discouraging. Therefore, the identification of effective preventative measures or treatments is of great importance. In this study, the substantial potential of naringin (NG) to reduce peritoneal adhesions was validated in a rat model. Materials and Methods A rat peritoneal adhesion model was established by abrasion of the cecum and its opposite intraperitoneal region under aseptic surgical conditions. After the operation, three groups of NG-treated rats were given 2 mL of NG by gavage at different concentrations (40, 60, or 80 mg/kg/d). The sham, control, and hyaluronan (HA) groups were given equal volumes of normal saline daily. On the 8th day, all rats were sacrificed 30 min after the administration of an activated carbon solution (10 mL/kg) by oral gavage. Intraperitoneal adhesion formation was adequately evaluated by necropsy, hematoxylin and eosin (HE) staining, Sirius red staining, immunofluorescence staining, enzyme-linked immunosorbent assays, and reactive oxygen species (ROS) probes. The gastrointestinal dynamics of the rats were assessed on the basis of a small intestinal charcoal powder propulsion test and the detection of motilin and gastrin levels in serum. Results Intraperitoneal adhesions were markedly reduced in the group of rats receiving high-dose NG. Compared with the control group, the high-dose NG group showed clear reductions in inflammatory reactions, oxidative stress, collagen deposition, and fibroblast formation in the adhesion tissue and enhanced gastrointestinal dynamics (P < 0.05). Conclusion NG alleviated the severity of intraperitoneal adhesions in a rat model by reducing inflammation, oxidative stress, collagen deposition, and fibroblast formation, highlighting the potential of NG as a drug candidate to prevent postoperative peritoneal adhesion formation.

Effect of intra-abdominal administration of ascites fluid on postoperative peritoneal adhesion in rat model: A randomized controlled trail

IntroductionIntra-abdominal adhesions are typically found after the most surgical procedures. Normally, most adhesions are asymptomatic; however, few individuals experience postoperative adhesion-related problems such as small bowel obstruction, pelvic pain, infertility, or other complications. We aimed to evaluate the preventive effect of the ascites fluid for postoperative peritoneal adhesions in rat models. Material and methodsThis experimental trial was conducted in Sixty Syrian male rat randomly assigned to six groups of 10 animals each as follows: control (group 1&4); normal saline (group 2&5): 2 mL of normal saline was poured into the peritoneal cavity; and case (group 3&6): 2 mL ascites fluid was poured into the peritoneal cavity. All animals in the six groups underwent laparotomy and measurable serosal injury were created with a standard technique. 10 and 30 days after initial surgery, the rats underwent another laparotomy in groups 1, 2, 3 and 4, 5, 6, respectively to assess macroscopic and microscopic adhesions, which were scored by an examiner who was blind to the animals̕ group assignment. Data analyzed by SPSS version 18, using the kruskal Wallis and Bonferroni-corrected Mann-Whitney U tests. P-values of less than 0.05 were considered significant. ResultsThe mean scores of both microscopic and macroscopic adhesion were significantly different between all the groups (P < 0.05). Total macroscopic and microscopic adhesion scores were significantly lower in the ascites fluid treatment than in the control (P = 0.0001) or the normal saline (P < 0.001) group. There was no significant difference between adhesion intensity 10 and 30 days after laparotomy (P > 0.05). ConclusionsAscites fluid can decrease the possibility of post-operative intraperitoneal adhesion formation.

The effectiveness of Triamcinolone Acetonide (TA) and Interleukin-6 (IL-6) levels in preventing intraperitoneal adhesion

Background: Intraperitoneal adhesions are formed due to the inflammatory response in releasing proinflammatory cytokines such as IL-6. Triamcinolone Acetonide (TA) acts as an anti-inflammatory by inhibiting the production and release of IL-6 cytokines. This study aims to determine the effectiveness of triamcinolone acetonide in preventing intraperitoneal adhesions and its effect on assessing IL-6 levels in post-exploratory laparotomy in rats.Methods: An experimental study was conducted among 40 male Wistar rats from January and March 2021 in the Animal Laboratory of Universitas Padjadjaran, Bandung, Indonesia. Blood samples were taken before treatment and on the 14th day after treatment. In rats, laparotomy and cecum abrasion were performed with a needle. Rats in the treatment group were given triamcinolone acetonide at a dose of 0.1 mg, 0.3 mg, or 0.5 mg. On the 14th day, a microscopic examination of the degree of adhesion was performed. Data were analyzed using SPSS version 20 for Windows.Results: The results of the Kruskal-Wallis test analysis on the formation of intraperitoneal adhesions microscopically showed a significant difference between the control group and the treatment group (p &lt; 0.001) with the lowest mean rank in the TA group of 0.3 mg (11.4), which stated that this dose was more effective in preventing intraperitoneal adhesions. The One-Way ANOVA test on IL-6 examination had a significant difference in postoperative IL-6 reduction between the control and treatment groups (p &lt; 0.001).Conclusion: Triamcinolone acetonide was effective in preventing intraperitoneal adhesions and reducing IL-6 levels in post-exploratory laparotomy rats.

Prediction and prevention of postoperative intra-abdominal adhesive complications in children

The aim of this work was to study the morphology of adhesion formation under the influence of ozone in the experiment, as well as the development of prediction criteria and methods for correcting increased adhesion in children.Materials and methods. Experimental studies were carried out on 36 rabbits «Shinshilla» with a body weight of 0.7–1.2 kg., of which 12 animals were included in the control group, which did not carry out ozonation of the abdominal cavity. The main group consisted of 24 rabbits, which were divided into two subgroups (12 animals in each subgroup), which ozonized the abdominal cavity with an ozone-oxygen mixture. In order to study the prognostic value of the acetylation phenotype in the formation of intraperitoneal adhesions, 67 children with symptoms of adhesive intestinal obstruction were examined.Results. The results of experimental studies showed that in animals of the control group there was the formation of massive adhesions. The basis of adhesions is connective tissue with a significant number of fibroblasts, blood vessels and collagen fibers. In animals of the main group, sharp inhibition of adhesion formation, a delay in the differentiation of fibroblasts and inhibition of their synthetic function were revealed. Acetylation phenotype was determined in 58 patients with appendicular peritonitis. 30 (51%) children turned out to be slow acetylators, and in 28 (49%) patients the phenotype of fast acetylation was established. The results of the study allowed us to isolate fast acetylators as a risk group for excessive adhesion formation and timely start therapeutic and preventive measures.

Novel technical modifications of hand-assisted laparoscopic dissection of a large obturator mass: A case report and literature review.

Laparoscopic lateral pelvic tumor dissection (LLPTD) for transobturator tumors may be technically challenging due to the requirement for sufficient operative space. The present study discusses a technique modification with combination of the laparoscopic approach and hand-assisted (HA) open surgery for patients with large obturator masses. LLPTD was performed using the combined approach, defined as HA-LLPTD, with one case treated. According to this technique, a combined working space is constructed based on the outreached laparoscopic space and open extraperitoneal approach, followed by HA-LLPTD. Finally, a literature review was performed to retrospectively evaluate 17 cases of obturator tumors, in terms of tumor type and operative approach. The tumor in the present case was successfully and completely resected, without any obvious intra- and post-operative complications. Based on the literature review, the majority of the cases were benign (~75%) and originated from neurological tissue (~50%). The selection of the operative approach was either open or minimally invasive (50% each). HA-LLPTD allows experienced urological laparoscopic surgeons to safely and completely perform obturator surgery without obstruction of the obturator foramen or formation of intraperitoneal adhesions and associated complications. Therefore, HA-LLPTD may be more useful for transobturator tumor resection compared with the conventional intraperitoneal approach.

1454 Intrauterine Device Perforation and Adhesion Formation

Study Objective To compare the potential for adhesion formation between metal containing and levonorgestrel releasing IUD, once uterine perforation occurred. Design PubMed electronic search with key words and subject heading “intrauterine device” and “perforation” was performed Setting N/A Patients or Participants 75 articles, describing 85 cases, between 1965 to 2016 were included in the study. Interventions Patient demographics, class of IUD, site of adhesion formation and the description of these adhesions were tabulated. Adhesions were classified into 3 groups (Group I, II and III) based on the degree of the adhesions (dense/severe to filmy). The degree of intra-peritoneal adhesion formation and the class of IUD was analyzed. The statistical test to analyze the contingency table for the three groups was Chi square test. The p value of Measurements and Main Results Metal containing perforated devices were found to have a statistically higher number of dense adhesions compared to levonorgestrel releasing IUD (p=.000056). The sigmoid colon (22%) was found to be the most common site of adhesions formation following perforation of IUD. Laparotomy was performed in the majority of cases in which a metal containing IUD had perforated. Conclusion The degree of intra peritoneal adhesion formation is significantly higher in metal containing perforated IUD, and this may contribute to further complications such as visceral perforation, bowel obstruction and need for more extensive procedures such as appendectomy or bowel resection. Further studies are warranted to establish the significance of this in patient selection criteria.

Pharmacological Mobilization and Recruitment of Stem Cells in Rats Stops Abdominal Adhesions After Laparotomy

Adhesions are a very common complication in the abdominal surgery. Animal studies and human trials have evaluated strategies designed to reduce and prevent postsurgical adhesions but few have an evidence base that justifies routine use. A strategy to prevent adhesions effectively remains an urgent need. We studied a reproducible model of intra-peritoneal adhesion formation in rats using laparotomy with several peritoneal sutures to produce the adhesions. Here we show that entraining endogenous stem cells into injury sites using the combined effect of AMD3100 and low-dose FK-506 (AF) can reduce the adhesion score significantly and abolish peritoneal adhesions in 45% of animals in a rat model of severe postsurgical intra-abdominal adhesions, compared with saline controls. Searching for mechanisms, we found AF treatment dramatically increased SDF-1 expressing cells, HGF expressing Ym1+ M2 macrophages and CD133+ stem cells in the injury sites of peritoneal surface at day 5 post-operation. Our results demonstrate that medically induced recruitment of autologous stem cells using AF significantly reduced postsurgical intra-abdominal adhesions. These findings suggest a novel effective therapeutic approach to preventing adhesions in patients.

Su1020 – Nafamostat Mesylate, a Broad Spectrum Serine Protease Inhibitor, Reduces Intraperitoneal Adhesion Formation in a Murine Caecal Ligation and Puncture Model for Sepsis

Su1020 – Nafamostat Mesylate, a Broad Spectrum Serine Protease Inhibitor, Reduces Intraperitoneal Adhesion Formation in a Murine Caecal Ligation and Puncture Model for Sepsis

Spilt bile and gallstones effect during laparoscopic cholecystectomy: an experimental study for adhesion formation

Laparoscopic cholecystectomy (LC) is recognized as the standard treatment for symptomatic gallstone disease. In comparison with open techniques, LC results in a higher rate of iatrogenic biliary tract damage and spillage of bile and stones. The present study was designed to compare intraperitoneal adhesion formation following LC due to the bile and stone spillage. In this randomized experimental study, 15 dogs were randomly allocated to three groups. Each group contained five dogs. The control group underwent LC, while in the group of bile and stone spillage (BS), 5 cc of a mixture of dog bile and a sterile ground human gallstone was placed in the bed of the gallbladder following LC. The bile spillage (B) group underwent LC, followed by adding 5 cc of the bile in the bed of the gallbladder. Postsurgical adhesion formation was measured, using Nair and Zuhlke classifications for inflammation, fibrosis, and neovascularization. Adhesion formation was noted in one dog from the control and B groups, whereas all animals in group 2 were found to develop high-grade adhesion. Bile cultures were negative for the control group and group B with adhesion. Based on the findings, bile spillage, as well as gallbladder stone spillage, is related to a significant increase in adhesion formation after LC. Therefore, it is necessary to avoid the bile and stone spillage.

The Effect of Single-Dose Intraperitoneal Bevacizumab on Peritoneal Adhesion Formation.

Intra-abdominal adhesions and their complications following abdominal surgery are serious problems, with an incidence of 67-93%. Prevention of peritoneal adhesion formation may eliminate the need for surgical intervention, decreasing complications, morbidity, and cost. Bevacizumab is a recombinant monoclonal antibody which specifically binds vascular endothelial growth factor, an important cytokine in adhesion formation, and neutralizes its biological activity. We developed an experimental model in rats to determine the effect of bevacizumab in preventing adhesion formation and analyzed its effect both micro- and macroscopically. We used 32. Wistar rats randomly divided into two groups: Group A (control) and Group B (bevacizumab), with 16 rats each. A modified cecum abrasion model was developed; 0.9% NaCl solution was administered intraperitoneally to Group A and bevacizumab to Group B. On day 15, adhesion formation was evaluated both macro- and microscopically. Both micro- and macroscopic adhesion grades in Group B were significantly lower than those of control Group A; macroscopic grades were 2.69 ± 0.95 and 0.69 ± 0.8, and microscopic grades were 2.25 ± 1.06 and 0.5 ± 0.52 for Groups A and B, respectively. Bevacizumab was effective in preventing intraperitoneal adhesion formation in our study; however, its inhibitory effects on embryogenesis and the hematopoietic, endocrine, and immune systems may limit its clinical use.

The preventive effect of ambroxol hydrochloride chitosan on postoperative intraperitoneal adhesion formation in a rat model

Background: This study aimed to investigate the effects of ambroxol hydrochloride chitosan reduced the degree of peritoneal adhesion.Methods: A total of 120 Sprague–Dawley (SD) rats were experimented, group A: the damaged peritoneal was covered with ambroxol hydrochloride chitosan, group B: chitosan membrane only, group C: nothing. Enzyme-linked immunosorbent assay (ELISA), western blotting, and immunohistochemistry (IHC) were used to observe the expression of TNF-α and NF-κB p65.Results: TNF-α and NF-κB p65 in group A significantly decreased in comparison with the controls. IHC showed TNF-α and NF-κB p65 were significantly down-regulated in group A. Adhesion grade in the treatment group was significantly lower than in controls.Conclusion: Ambroxol hydrochloride chitosan reduced the degree of peritoneal adhesion.

Poly(dopamine)-inspired surface functionalization of polypropylene tissue mesh for prevention of intra-peritoneal adhesion formation.

Polypropylene (PP), as one of the most common prosthetic materials, has been widely used in intra-peritoneal repair. However, its adhesion to viscera has severely limited its application. Therefore it is critical to improve the PP surface with an anti-adhesion property. In this work, based on dopamine-inspired chemistry, virgin PP (V-PP) mesh was first pretreated with O2 plasma, subsequently dipped in dopamine aqueous solution for 24 h, and then chitosan (CS) was grafted onto it. Finally the anti-adhesion mesh (O-PP/PDA/CS) was obtained. The formation procedure of a PDA/CS ad-layer was characterized by water contact angle measurements, ATR-FTIR, SEM, and XPS. The results show that a PDA/CS ad-layer could be coated on the PP surface efficiently. NIH/3T3 cells were first cultured on O-PP/PDA/CS meshes to evaluate the availability of anti-adhesion and biocompatibility in vitro, and then the efficacy of the PDA/CS-coating as a barrier for reducing postsurgical adhesions was evaluated using a rat abdominal wall defect model. Compared with the V-PP group, NIH/3T3 cells exhibited higher viability in the O-PP/PDA/CS groups as evaluated by the CCK-8 method. In addition, NIH/3T3 cells grow into round-shapes on the O-PP/PDA/CS surface. This indicates that the modification strategy can facilely lead to excellent properties of anti-adhesion. In vivo tests further indicate that O-PP/PDA/CS meshes were effective in reducing adhesion formation.

Comparison between polypropylene and polypropylene with poliglecaprone meshes on intraperitoneal adhesion formation.

to compare intraperitoneal adhesion formation in rats when using polypropylene and polypropylene with poliglecaprone meshes. we used twenty male, Wistar rats, divided in two groups. In group 1, the rats received the polypropylene mesh on their right side and the polypropylene with poliglecaprone mesh on their left side. In group 2 the position of the meshes was inverted. After 30 days, we analyzed the presence or not of adhesion formation, including only those over the meshes. The findings undergone an analysis through the Mann-Whitney test, at a level of significance of p≤0.05. all meshes presented adhesions. We verified that, for the polypropylene meshes, the percentage of their surface covered by adhesions varied from 10.5 to 100%, with an average of 34.07±24.21%, while for the polypropylene with poliglecaprone mesh, the percentage covered by adhesions varied between 8.5% and 100%, with an average of 44.7±32.85% (p=0.12). both meshes lead to adhesion formation, none being superior to the other.

Preventing intraperitoneal adhesions with ethyl pyruvate and hyaluronic acid/carboxymethylcellulose: a comparative study in an experimental model

ObjectiveTo compare the effectiveness of ethyl pyruvate (EP) with that of hyaluronic acid+carboxymethyl cellulose (Seprafilm) for the prevention of intraperitoneal adhesions. Seprafilm has been shown to be effective in many experimental and clinical studies. Study designThirty rats were divided into three groups at random, and uterine horn abrasion was performed by laparotomy. One group received no treatment (control group), one group received a single intraperitoneal dose of EP 50mg/kg (EP group), and a 2×1-cm patch of Seprafilm was applied in the third group (Seprafilm group). All rats were killed 14 days after surgery. Macroscopic and histopathological evaluation were performed by a surgeon and a pathologist who were blinded to group allocation. Histopathologically, inflammation, fibroblastic activity, foreign body reaction, collagen proliferation, vascular proliferation, Masson-Trichrome score, matrix metalloproteinase-2 score and vascular endothelial growth factor score were studied. ResultsMedian macroscopic intraperitoneal adhesion scores for the control, EP and Seprafilm groups were 2.8, 1.2 and 1.1, respectively. Multiple comparisons between groups showed a significant difference (p<0.05). In binary comparisons, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.05). No significant difference was found between the adhesion scores for the EP group and the Seprafilm group (p>0.05). After histopathological evaluation, significant differences in all parameters were found between the groups (p<0.05). In the paired comparison, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.0167), but no significant difference was found between the EP group and the Seprafilm group (p>0.0167). ConclusionsIn comparison with the untreated control group, EP and Seprafilm were found to reduce the formation of intraperitoneal adhesions. No significant difference was found between EP and Seprafilm.

Preventing intraperitoneal adhesions with linezolid and hyaluronic acid/carboxymethylcellulose: a comparative study in cecal abrasion model

BackgroundWe aimed to compare the effectiveness of linezolid in preventing intraperitoneal adhesions with hyaluronic acid + carboxymethylcellulose (Seprafilm). MethodsThirty rats were divided randomly into 3 groups: Group I (control), untreated; Group II (Seprafilm); and Group III (linezolid). All rats were sacrificed on the 14th day after surgery. Macroscopic adhesion, inflammation, and fibrosis were evaluated. ResultsThe multiple comparisons between groups showed a statistically significant difference for adhesion. There were statistically significant differences between Group I and II and I and III, but no statistically significant difference between Group II and III. The multiple comparisons between the groups showed a statistically significant difference for inflammation and fibrosis. For inflammation and fibrosis, there was a statistically significant difference between Group I and II and I and III, but no statistically significant difference between Group II and III. ConclusionThe efficiency of linezolid in reducing the formation of intraperitoneal adhesions was statistically significant compared with the control group.