Effect of IntraperitonealPERIDAN™Concentrate Adhesion Reduction Device on Clinical Findings, Infection, and Tissue Healing in an Adult Horse Jejunojejunostomy Model

Abstract

PERIDAN™ Concentrate was safely administered intraperitoneally to healthy horses undergoing celiotomy and anastomosis.

Comparison of short‐ and long‐term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005–2010

“…The technique is easy to perform and needle placement is not as critical as it is with an inverting pattern. Historically there has been concern with post operative intraperitoneal adhesion formation with suture exposure following an appositional pattern; however, in a relatively large number of experimental JJ procedures there were no adhesions with this anastomosis technique . The current study was not randomised and does not take into consideration the impact of surgeon experience.…”

Meta‐Analysis of the Effects of Adhesion Barriers on Adhesion Formation in the Horse

“…The study by Eggleston evaluating an HA solution had an OR=0.077 (95% CI [0.003, 1.955]; P =.120), suggesting no effect . The OR for adhesions in horses treated with fucoidan solution in the paper by Morello was also not significantly different from the control groups (OR 1.00; 95% CI [0.017, 58.434]; P =1.00) …”

“…The types of adhesion models used to induce adhesions, as well as peri‐operative therapies, varied widely in these studies. Some studies used jejunal anastomoses only, while a single study by Moll used serosal abrasions with a dry gauze in conjunction with suture placed in the abraded area to stimulate reaction to a foreign body . Most studies used a combination of a number of distinct abrasion sites, with one or more jejunal anastomoses to simulate bowel resections or enterotomies .…”

“…A total of 7 of the comparisons in this meta‐analysis administered systemic antibiotics (penicillin, gentamicin) and non‐steroidal anti‐inflammatory medications (flunixin meglumine) for 48 hours peri‐operatively . Morello treated with antibiotics for 24 hours and flunixin meglumine for 72 hours . A single study by Lopes did not use perioperative anti‐inflammatories, but did administer 24 hours of antibiotics, and separate study by Moll did not administer either antibiotics or anti‐inflammatory medications .…”

“…The veterinary literature reports that these barriers reduce the frequency of adhesions in clinical cases; however, these are often observational reports of patient survival, rather than evidence of efficacy . There are experimental studies that have tested these materials in horses and while some have shown a reduction in the frequency of adhesions using adhesion barriers, others have shown no effect in controlled, randomized trials . Therefore, the goal of this study was to perform a meta‐analytic review of adhesion barriers tested experimentally in horses and to identify the effect of these agents on adhesion formation.…”