A Novel Method of Comparing Anti-Adhesive Agents Used to Prevent Postoperative Peritoneal Adhesions

Abstract

Aim: In this study, our aim was to utilize a novel and objective method of adhesion evaluation and compare the effectiveness of anti-adhesive properties of commonly used agents, such as sodium hyaluronate and carboxymethylcellulose membrane (HA-CMC), polyethylene glycol lysine (PEG-L), and sodium hyaluronic acid (HA). Method: Cecal abrasion was performed on 64 female Wistar albino rats (250-300 g) which were randomized into two equivalent groups, one group was sacrificed on postoperative day 5 (group 1), and the other on postoperative day 14 (group 2). Each group was subcategorized to four groups according to applied anti-adhesive material: PEG-L, sodium HA-CMC, HA, and control group. Adhesions were evaluated with conventional methods and the novel “Zone Calculation” method. Results: In group 1, no significant differences were found with any of the evaluation tools. However, in the PEG-L subgroup of the group 2, adhesion zone score was higher with the zone calculation method. The same subgroup was found to have a higher inflammation score on histopathological evaluation; however, other results were similar. Conclusion: Although histopathological results and macroscopic evaluations were similar in all groups, the zone calculation method indicated greater adhesion in the PEG-L subgroup. Conventional evaluation methods of adhesion are considered to be semi-quantitative, whereas the zone calculation method does not allow subjectivity. We believe this method can replace conventional methods and can be used in studies evaluating anti-adhesive agents/materials.

Keywords

• Sepracoat
• seprafilm
• SprayShield
• preventing adhesions
• animal experiment