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Polyanionic polysaccharides reduce intra-abdominal adhesion and abscess formation in a rat peritonitis model
M M Reijnen1, E M Skrabut, V A Postma
1Department of Surgery, University Medical Center Nijmegen, Nijmegen, The Netherlands. mmpj.reijnen@worldonline.nl
The Journal of Surgical Research
|December 12, 2001
Summary
Carboxymethylcellulose (CMC) and low-concentration hyaluronan (HA) solutions effectively reduced intra-abdominal adhesions and abscesses in a rat peritonitis model. High volumes of HA and varying volumes of CMC demonstrated significant efficacy.
Area of Science:
- Surgical Research
- Peritonitis Management
- Biomaterials Science
Background:
- Intra-abdominal infections frequently lead to adhesion and abscess formation.
- Polyanionic polysaccharides like hyaluronan (HA) and carboxymethylcellulose (CMC) are investigated for their potential to mitigate these complications.
- A standardized rat peritonitis model was employed to evaluate their efficacy.
Purpose of the Study:
- To assess the adhesion- and abscess-reducing capacity of varying solution volumes and concentrations of HA and CMC.
- To compare the effectiveness of HA and CMC in preventing post-infectious complications.
- To investigate the influence of volume and concentration on the efficacy of these polysaccharides.
Main Methods:
- Bacterial peritonitis was induced in 192 male Wistar rats via cecal ligation and puncture.
- Animals were randomized into control groups and treatment groups receiving different volumes (1-8 ml) and concentrations of HA or a 1.7% CMC solution.
- Adhesions were scored, and the presence and size of abscesses were recorded on postoperative day 7.
Main Results:
- Treatment with CMC (P < 0.001) and low concentrations of HA (0.2-0.4%, P < 0.005) significantly reduced intra-abdominal adhesion formation.
- High volumes of low-concentration HA were most effective for adhesion reduction (P = 0.01), while CMC's effect was volume-independent.
- Both CMC (P < 0.001) and low-concentration HA (P < 0.001) significantly decreased abscess incidence, with HA's effect being volume-independent and low volumes of CMC being most effective.
Conclusions:
- Intraperitoneal administration of CMC or low-viscosity HA solutions effectively reduced intra-abdominal adhesion and abscess formation in a rat peritonitis model.
- The findings suggest a potential hydroflotation mechanism for HA in reducing adhesion formation.
- Both agents represent promising therapeutic options for managing complications of intra-abdominal infections.