Role of single-dose clostridiopeptidase A collagenase in peritoneal adhesions

To evaluate the effect of clostridiopeptidase A collagenase (CAC) in a rat model of postoperative peritoneal adhesion (PPA).

Forty rats were divided into four equal groups. In group 1, 1 g CAC was injected into the peritoneal cavity. In group 2, adhesions were generated. In group 3, adhesions were generated, and, 10 days later, the area with PPAs was covered with 1 g CAC. In group 4, adhesions were generated and the area was covered immediately with 1 g CAC. All rats were sacrificed on postoperative day 10, and adhesions were scored both macroscopically and microscopically.

Mean macroscopic adhesion scores in groups 1-4 were 0, 2.9 ± 0.21, 2.55 ± 0.16, and 1.3 ± 1, respectively (p = 0.0001). The mean macroscopic adhesion score in group 4 was lower than that in group 2 (p = 0.045). The mean macroscopic adhesion score in group 4 was lower than that in group 3, but the value was not statistically different (p = 0.098). Mean microscopic values were 0, 2.8 ± 0.42, 2.5 ± 0.52, and 1.3 ± 0.67, respectively (p< 0.0001). The group 4 score was lower than those of groups 2 (p = 0.01) and 3 (p = 0.025).

A single dose of CAC reduces PPA formation. CAC, however, is not effective on already formed PPAs.