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Effects of pirfenidone and dermoid cyst fluid on adhesion formation
S al-Took1, C Murray, T Tulandi
1Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Objective:
To evaluate the effects of pirfenidone and human dermoid cyst fluid on adhesion formation in a rat model.
Design:
A prospective, blinded, controlled study.
Setting:
Sprague-Dawley white rats in a conventional laboratory setting.
Intervention(S):
Rats were divided into four groups according to the type of solution tested (dermoid fluid, 0.05 mg of pirfenidone, normal saline, and a combination of dermoid fluid and pirfenidone). In the first experiment, the solution (0.5 mL) was injected intraperitoneally. In the second experiment, the solution was instilled intraperitoneally after a standardized injury to the right uterine horn. The degree of adhesion formation was evaluated 2 weeks after the initial surgery.
Result(S):
Human dermoid cyst fluid caused adhesion in 4 of 10 intact rats and in 9 of 10 standardized injured rats. Pirfenidone did not decrease adhesion formation. No adhesion was found after injection of saline or pirfenidone in intact rats. The mean +/- SEM adhesion score in standardized injured rats was higher in the dermoid group (4.6 +/- 0.6) than in the pirfenidone group (2.8 +/- 0.7) or the saline group (3.8 +/- 0.5). The mean +/- SEM adhesion score in intact rats was 0.6 +/- 0.3 after dermoid fluid injection and after dermoid instillation in standardized injured rats was 4.6 +/- 0.6.
Conclusion(S):
Human dermoid fluid causes adhesion formation even in intact rats, and the adhesion is worse in the presence of serosal injury. Intraperitoneal pirfenidone does not decrease adhesion formation.