A Novel Hydrogel-Coated Polyester Mesh Prevents Postsurgical Adhesions in a Rat Model

Berberine Hydrochloride Prevents Postsurgery Intestinal Adhesion and Inflammation in Rats

“…To determine the severity and incidence of adhesion, the adhesion formation was classified into six grades, using a predetermined adhesion measurement score (Townsend et al, 2011): grade 0, no adhesions; grade 1, loose, filmy adhesions that could be separated by blunt dissection; grade 2, adhesions requiring ,50% sharp dissection for separation; grade 3, adhesions requiring .50% sharp dissection for separation; grade 4, serosal injury; and grade 5, fullthickness injury (as described in Supplemental Table 1). Examples of photographic images at post-mortem evaluation of adhesions on day 14 after the surgery are displayed in Supplemental Fig.…”

“…1). After the cecum was returned to the abdomen, the midline incision was closed in two layers with 5-0 nylon (Townsend et al, 2011). For sham control animals, approximately 2.0 ml of normal saline was dropped into the abdominal cavity after the laparotomy surgery.…”

“…The abdominal wall was then opened fully to examine the extent of adhesions. The adhesions were graded by the scoring system developed from previously validated comparisons (Townsend et al, 2011). This method, taking into account number, strength, and distribution, provides a more objective measurement of adhesion formation.…”

“…Inflammation was scored as follows: 0, nil; 1, giant cells with occasional scattered lymphocytes and plasma cells; 2, giant cells with increased numbers of admixed lymphocytes, plasma cells, eosinophils, and neutrophils; and 3, numerous admixed inflammatory cells with microabscesses present. Vascular proliferation was scored as follows: 0, no vascular proliferation; 1, mild proliferation; 2, moderate proliferation; and 3, intense proliferation (Townsend et al, 2011).…”

“…Studies have reported that the incidence of adhesions is over 90% (Chaturvedi et al, 2013;Takagi et al, 2013), and adhesions can also develop after abdominal bacterial infections, such as peritonitis (van Goor, 2007). Peritoneal adhesion is one of the leading causes of intestinal obstruction, up to 40% of all cases (Ellis, 1997), with 60-70% of the cases involving the small bowel (Townsend et al, 2011). Postsurgical adhesions are a principal factor that contribute to increased mortality and morbidities (Emans et al, 2009;Yigitler et al, 2012), such as life-threatening ileus, chronic abdominopelvic discomfort, chronic pelvic pain, infertility, dyspareunia, and intestinal obstruction, accounting for approximately 75% of all cases (Miller et al, 2000;Ghosheh and Salameh, 2007;Izumi et al, 2007).…”