Prevention of postoperative peritoneal adhesions

Kamel, Remah M

doi:10.1016/j.ejogrb.2010.02.003

Cited by 105 publications

(102 citation statements)

References 64 publications

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“…Bleeding, cauterization, ischemia, infections, and conditions that may damage the peritoneum may trigger adhesions [5][6][7] . While numerous cells such as mesothelial cells, histiocytes, fibroblasts, and lymphocytes help in healing the injured area, they also play a role in the development of peritoneal adhesion [2][3][4][5] .…”

Section: ■ Discussionmentioning

confidence: 99%

“…The etiopathogenesis of peritoneal adhesions is not precisely known; however, inflammation, ischemia, and the presence of oxidative stress may be prevalent its etiopathogenesis 2,4-6 . Many types of steroids and non-steroidal antiinflammatory, fibrinolytic, and antioxidant agents as well as different techniques have been used to reduce or prevent the formation of postoperative peritoneal adhesions 2,5,7 . Additionally, conditions such as inflammation and infection that are secondary to intraabdominal operations may cause adhesions, whereas they may be responsible for the etiopathogenesis of lymphadenopathy that may develop secondary to inflammation 2,7 .…”

Section: ■ Introductionmentioning

confidence: 99%

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The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats

Göret¹,

Göret

Kiraz

et al. 2018

Acta Cir. Bras.

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Purpose: To investigate the effects of pycnogenol on peritoneal adhesions and additionally to investigate the immunohistochemical effects of free oxygen radicals and reactive lymph nodes detected in the adhesive tissue that was sampled surrounding the cecum on intraabdominal adhesions. Methods: Twenty-seven Wistar Albino rats were divided into three groups. In group 1 (sham), laparotomy was performed and stitched up. In group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered 2 cc of saline. In group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Pycnogenol derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum, and the rats were sacrificed. Results: In group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that pycnogenol reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Moreover, a significant increase in lymph node size was detected secondary to inflammation. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, pycnogenol increased the production of free oxygen radicals in the tissue.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats

Göret¹,

Göret

Kiraz

et al. 2018

Acta Cir. Bras.

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“…On one hand, this deposition of fibrin is an essential component of normal tissue repair, but on the other hand, resolution of this fibrin deposit is required to restore conditions before surgery [1,10,20].…”

Section: Discussionmentioning

confidence: 99%

“…Considering that pentoxifylline may alter plasma fibrinolytic activity [5] and that streptokinase acts directly through the breakdown of the fibrinous mass [1], the main aim of the present study was to investigate the effects of oral gavage administration of pentoxifylline (a methylxanthine-derived phosphodiesterase inhibitor) and intraperitoneal (i.p.) injection of streptokinase (a fibrinolytic agent) alone and/or coadministration on postoperative intra-abdominal adhesion formation in mice.…”

Section: Introductionmentioning

confidence: 99%

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Pentoxifylline Increases Antiadhesion Effect of Streptokinase on Postoperative Adhesion Formation: Involvement of Fibrinolytic Pathway

et al. 2014

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Pentoxifylline reduces peritoneal adhesions and increases peritoneal fibrinolysis in rodents. Furthermore, the activation of the fibrinolytic system by streptokinase leading to degradation of fibrin is effective in the prevention of adhesion formation. We have investigated the effects of pentoxifylline and streptokinase alone and/or coadministration on postoperative intra-abdominal adhesion formation in adult female NMRI mice. Drugs were administered from the day of surgery until 10 days after surgery. At relaparotomy 11 days after surgery, the abdomen was opened, and the adhesions were graded in a blinded fashion utilizing the classification system described. Oral gavage administration of lower doses of pentoxifylline (3.125, 6.25, and 12.5 mg/kg) had no significant effect on postsurgical adhesion formation, while the higher doses of pentoxifylline (25 and 50 mg/kg) significantly decreased postsurgical adhesion formation. Moreover, intraperitoneal injection of lower doses of streptokinase (9.375, 18.75, and 37.5 unit/kg, i.p.) had no significant effect on postsurgical adhesion formation, while the higher doses of streptokinase (75 and 150 unit/kg) significantly decreased postsurgical adhesion formation. In other series of experiments, coadministration of lower doses of pentoxifylline and streptokinase doses, which were ineffective when given alone, significantly decreased postsurgical intra-abdominal adhesion formation compared with streptokinase control group. The results suggest that pentoxifylline may interfere with streptokinase in the reduction of postoperative intraabdominal adhesion formation by enhancing local fibrinolytic activity.

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Manufacture of electrospun porous PLA fiber‐type film coated with CMC and its anti‐adhesion efficiency in white mice

Choi

Chung

Kim

et al. 2023

Bulletin Korean Chem Soc

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The electrospun polylactide (PLA) anti‐adhesion fiber‐type film coated with carboxymethylcellulose (CMC) was manufactured and evaluated for its usability through animal experiments. The PLA anti‐adhesion film developed in this study is an adhesion preventive film of a double composite structure with both hydrophobicity and hydrophilicity. This film has the anti‐adhesion effect due to hydrophobic PLA that do not melt easily in the body and at the same time is easily attached to the surgical site by hydrophilic CMC that reacts easily to body fluids and changes quickly to mucus. In this study, the diameter and the pore diameter of the PLA fiber and thickness of PLA film made by electrospinning was 0.2–0.4, 1–10, and 30–50 μm, respectively. Through observation of surface structure (×5000 magnification), the most suitable concentration of CMC to maintain pores on the PLA film as much as possible is 0.5% wt/vol. The CMC content in the PLA film coated with 0.5% wt/vol of CMC was measured to be 5.41% wt/wt and its tensile strength was about 2.92 times higher than that of the noncoated PLA film with CMC. The porosity of CMC‐coated PLA film (5.41% wt/wt) was found to be 76.4%. In the animal experiment, 20 white mice (10 as a control group and 10 as an experimental group) were used to determine the degree of adhesion prevention. As a result of observing adhesion and anti‐adhesion between the cecum and the peritoneum by performing U‐shaped laparotomy on white mice at the third week after surgery, the incidence of adhesion in the control group was 90%, whereas the experimental group was 20%.

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Prevention of postoperative peritoneal adhesions

Cited by 105 publications

References 64 publications

The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats

The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats

Pentoxifylline Increases Antiadhesion Effect of Streptokinase on Postoperative Adhesion Formation: Involvement of Fibrinolytic Pathway

Manufacture of electrospun porous PLA fiber‐type film coated with CMC and its anti‐adhesion efficiency in white mice

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