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Reduction of adhesion formation with cross-linked hyaluronic acid after peritoneal surgery in rats
1Department of Obstetrics and Gynecology, Ondokuz Mayis University School of Medicine, Samsun, Turkey. kocak@iname.com
Objective:
To examine the effectiveness of a cross-linked hyaluronan solution (auto-cross-linked polysaccharide [ACP] gel) for the prevention of postsurgical adhesions.
Design:
A randomized blinded study using a rat model of laparotomy.
Setting:
Surgical Research Laboratory in a university medical school.
Animal(S):
Sixty-seven sexually mature rats.
Intervention(S):
Standardized surgical trauma was induced in the rat uterine horn to induce adhesion formation. After trauma, group-1 animals (n = 23) received no treatment, group 2 (n = 21) received noncross-linked hyaluronic acid (HA), and group 3 (n = 23) received cross-linked HA applied on the lesion.
Main Outcome Measure(S):
Six weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Blauer's scoring system.
Result(S):
Overall, 84% of the untreated animals and 65% of the animals treated with noncross-linked HA presented with severe adhesions. The mean (+/-SEM) increase in the adhesion score was 2.46+/-0.23 in the untreated group, 2.23+/-0.29 in the group receiving noncross-linked HA, and 1.27+/-0.12 in the ACP gel group.
Conclusion(S):
ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparotomy.