Prevention of postoperative adhesions by precoating tissues with dilute sodium hyaluronate solutions

Postoperative adhesions (POA), the collagenous connective tissues which form in response to surgical trauma, can be a severe and life threatening surgical complication. However, no generally applicable methods are currently available to mitigate this often serious problem. We have investigated the use of dilute aqueous solutions of sodium hyaluronate (HA) as protective tissue coatings applied prior to surgical manipulation. In a random/blind rat cecal adhesions study conducted at three separate research centers, 0.4 wt% HA in buffered saline gave a three center average of 24% significant adhesions (n = 74) versus 87% for phosphate buffered saline (PBS) controls (n = 69). Histological data suggest that hyaluronic acid tissue precoating minimizes surgical trauma thereby inhibiting POA formation. Clinical studies have been initiated to evaluate the efficacy of tissue precoating with HA solutions in human surgery.