High molecular weight dextran--effect on adhesion formation and peritonitis in rats

Area of Science:

• Surgical Innovation
• Biomaterials in Medicine
• Gastrointestinal Surgery

Background:

• Intra-abdominal adhesions are a common complication following abdominal surgery, leading to significant morbidity.
• Preventing adhesions and ensuring anastomotic integrity are critical challenges in gastrointestinal surgery.

Purpose of the Study:

• To investigate the efficacy of 32% dextran 70 in mitigating intra-abdominal adhesion formation.
• To assess the impact of dextran 70 on intestinal leak rates and other post-operative complications.

Main Methods:

• A prospective, randomized, blinded study involving 100 animals subjected to various surgical procedures (sham laparotomy, intestinal abrasion, intestinal division and anastomosis).
• Animals received either 32% dextran 70 or saline at different volumes.
• Post-operative assessment at 2 weeks included grading of adhesions, examination for anastomotic leaks, and evaluation for peritonitis or abscesses.

Main Results:

• Intestinal division and anastomosis resulted in more severe adhesions compared to intestinal abrasion.
• Dextran 70 significantly reduced adhesion formation (P > 0.01).
• Dextran 70 was associated with peritonitis in 5/40 cases, whereas saline was linked to abscess formation in 7/40 cases.

Conclusions:

• 32% dextran 70 is effective in reducing post-operative intra-abdominal adhesions.
• While dextran 70 shows promise for adhesion prevention, its use may increase the risk of peritonitis.