Tranexamic acid and hyaluronate/carboxymethylcellulose create cell injury

Postoperative pelvic adhesions are associated with chronic pelvic pain, dyspareunia, and infertility. The aim of this study was to evaluate the adhesion prevention effects of tranexamic acid (TA) and hyaluronate/carboxymethylcellulose (HA/CMC) barrier in the rat uterine horn models on the basis of macroscopic and microscopic adhesion scores and histopathological as well as biochemical parameters of inflammation.

Twenty-one Wistar rats were randomly divided into 3 groups. Ten lesions were created on the antimesenteric surface of both uterine horns by bipolar cautery. Three milliliters of 0.9% sodium chloride solution were administered in the control group. A single layer of 2×2 cm HA/CMC was plated in group 2. Two milliliters of TA was applied in the last group. All rats were sacrificed at postoperative day 21.

No significant difference was found among the control group, the HA/CMC group, and the TA group in terms of macro-adhesion score (P=.206) and microadhesion score (P=.056). No significant difference was found among the 3 groups in terms of inflammation score (P=.815) and inflammatory cell activity (P=.835). Malondialdehyde levels were significantly lower in the control group than in the TA group and HA/CMC group (P=.028). Superoxide dismutase and glutathione S-transferase activities were found to be higher in the control group than in the TA group (P=.005) and HA/CMC group (P=.009).

TA and HA/CMC had no efficacy in preventing macroscopic or microscopic adhesion formation and decreasing inflammatory cell activity or inflammation score in our rat models. TA and HA/CMC increased the levels of free radicals and reduced the activities of superoxide dismutase and glutathione S-transferase enzymes, which act to reduce tissue injury.