Icodextrin and Seprafilm® Do Not Interfere with Colonic Anastomosis in Rats

Abstract

Background: Physical barriers and instilled solutions have been studied to prevent intra-abdominal adhesions. However, undesirable side effects of these substances on the healing of intestinal anastomoses may limit their use. This study was designed to compare the effects of antiadhesives on the healing of colonic anastomosis in rats. Methods: Sixty female Sprague-Dawley rats were divided into 3 groups of 20. The animals received isotonic saline and 7.5% icodextrin, intraperitoneally after standard left colonic anastomosis. In group 3, Seprafilm® was wrapped around the anastomosis and also laid over the abdominal viscera. Half of the animals from each group were killed on postoperative day (POD) 4 and the remaining half on POD 21. Adhesion scoring, bursting pressure and tissue hydroxyproline measurements and histopathological assessment were performed. Results: Mean hydroxyproline levels were significantly higher in groups receiving icodextrin and Seprafilm compared with the control group, whereas mean bursting pressures were significantly higher in the group that received icodextrin (p < 0.05). Intraperitoneal administration of icodextrin resulted in significant reduction of adhesion formation on POD 21 (p < 0.05). Conclusions: Seprafilm does not prevent formation of adhesions as much as icodextrin does, but its effect on the healing of colonic anastomoses is similar.

Separately and synergistic effects of taurolidine and icodextrin in preventing intraabdominal adhesions

“…Icodextrin is a solution whose adhesion preventive effects have been proven in preclinical and clinical studies. [26][27][28] Its ability to keep both damaged and non-damaged peritoneal surfaces apart makes it an ideal physical barrier. Icodextrin (4%) solution is not absorbed from the peritoneal space for 48 h; only half of it is absorbed in 96 h; thus, it continues showing its efficacy through the peritoneal surface for 3-5 days, which is a critical period for adhesion formation.…”

“…[29] Besides, icodextrin has no effect on wound healing. [27] In our study, we have used icodextrin 4% in group 3 animals. No adhesions of scores 3 and 4 have been detected.…”

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

“…Rodgers (21) found no significant difference between ID and Ringer's lactate used in rabbits that underwent intestinal anastomosis. Müller et al (15) showed that, in rabbits, phospholipids and ID reduced intraabdominal adhesions significantly compared to Ringer's lactate. Shamiyehi et al (8) generated serosal defects on four separate areas in the intraabdominal cavity of pigs and observed that HA significantly reduced the adhesions.…”

“…It persists for several days in the peritoneal cavity and is slowly absorbed by the lymphatic system into the systemic circulation, where it is broken down by amylase and metabolized to glucose (11). Several experimental and clinical studies have demonstrated the efficacy of ID in reducing postsurgical adhesion formation (11)(12)(13)(14)(15). In addition to these positive findings, the cheapness of the product is an advantage.…”

Effects of abdominal adhesion-preventing 4% icodextrin solution on healing of bowel anastomoses

“…[2][3][4][5][6] Gastrointestinal sistem anastomozları üzerine etkisi konusunda ise literatürde üç adet deneysel çalışmaya ulaşılmıştır. [7][8][9] Çalışmaların ikisinde anastomoz iyileşmesini olumsuz yönde etkilemediği belirtilirken bir tanesinde aksi yönde görüş bildirilmiştir. Bu üç çalışmada anastomoz iyileşmesi anastomoz patlama basıncı ölçümü, histopatolojik inceleme ve hidroksiprolin düzeyi ölçümümü yöntemlerinden biri veya birkaçı ile değerlendirilmiş, ancak, miyeloperoksidaz (MPO), nitrik oksit (NO) ve malondialdehit (MDA) gibi enflamasyon şiddetini ve doku hasarını gösteren biyokimyasal parametreler kullanılmamıştır.…”