Reduction of Postsurgical Adhesion Formation in the Rabbit Uterine Horn Model with Use of Hyaluronate/ Carboxymethylcellulose Gel

Leach, Richard E.; Burns, James W.; Dawe, Elizabeth J.; Smith-Barbour, M.; Diamond, Michael P.

doi:10.1016/s0015-0282(97)00573-6

Cited by 128 publications

(29 citation statements)

References 14 publications

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“…Control animals did not receive any HA film treatment or other barrier (n = 11), and this data was shared by a parallel study aimed at evaluating the antiadhesion efficacy of an in situ gelable hydrogel composed of modified chitosan and dextran [29]. The animals were sacrificed after 21 days and the extent of adhesion of the cecum to the site of abdominal injury was semi-quantitatively scored on a scale from 0 to 3 (0 = no adhesion, 1 = thin and filmy, 2 = significant and filmy, and 3 = severe with fibrosis) [16,28,30,31]. …”

Section: Methodsmentioning

confidence: 99%

Cross-Linked Hyaluronic Acid Films to Reduce Intra-Abdominal Postsurgical Adhesions in an Experimental Model

Falabella

Chen²

2009

Dig Surg

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Background/Aims: Intra-abdominal adhesions typically occur after surgically damaged tissues are situated in apposition, leading to fibrotic connections. The goal of this study was to demonstrate the in vivo efficacy of a cross-linked and insoluble hyaluronic acid (HA) film to reduce postsurgical adhesion in a rat model. Methods: To measure in vitro adhesion resistance, porcine monocytes were deposited on the surface of films and their attachment was monitored by scanning electron microscopy. A rat cecum abrasion and abdominal insult model was utilized to demonstrate in vivo efficacy. Briefly, an HA film was deployed as a barrier between the damaged cecal and abdominal tissue surfaces for 21 days; control animals did not receive treatment. At the study conclusion, the rats were sacrificed and the degree of adhesion was determined using a scale from 0 to 3, where 0 = no adhesion and 3 = severe fibrosis. Results: HA films resisted monocyte adhesion in vitro. The in vivo study results demonstrated a significantly lower mean adhesion score (0.625 ± 0.517) with HA film treatment compared to the controls (2.09 ± 1.22). Conclusion: Placement of HA films between injured tissues significantly decreases the severity of abdominal adhesions. Furthermore, the HA film’s resistance to monocyte adhesion could be contributory to lowering in vivo adhesion scores.

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Section: Methodsmentioning

confidence: 99%

Cross-Linked Hyaluronic Acid Films to Reduce Intra-Abdominal Postsurgical Adhesions in an Experimental Model

Falabella

Chen²

2009

Dig Surg

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“…There are numerous systems based upon these concepts [65,66,67], although little agreement between studies makes accurate comparison of results difficult. The lack of uniformity between study design and result reporting also makes a meta-analysis of existing data impossible.…”

Section: Models Of Adhesion Formationmentioning

confidence: 99%

Abdominal Adhesion Prevention: Still a Sticky Subject

et al. 2010

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Background: Adhesion formation remains an almost inevitable consequence of abdominal procedures, potentially resulting in significant morbidity and mortality. There is an ongoing need to evaluate current understanding of adhesion formation and products aimed at prevention. Failure to keep up to date with adhesion treatment may subject clinicians to a greater medico-legal risk. Design: Review of published studies exploring the problem of peritoneal adhesion formation. This encompasses the underlying processes of adhesion formation combined with general approaches to reduce formation. An overview of products trialled to prevent formation in both the animal model and clinical setting describes products of scientific interest and commercial success. Results: Advances in surgical technique, such as laparoscopic surgery, can help minimize the probability of adhesion formation. Currently barrier products, whilst reducing adhesion formation, have not been shown to reduce the risk of readmission with complications related to adhesions. Hybrid products may improve upon this situation. Conclusions: No single approach has been wholly satisfactory in reducing adhesions. Research into the processes driving adhesion formation is providing exciting new targets for therapeutic agents. It would seem plausible that with many promising avenues of research a revolutionary agent to reduce the incidence of adhesional small bowel obstruction may result.

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“…Intraperitoneal CAPE may enter traumatized peritoneal tissues suppressing fibroblast proliferation and collagen synthesis leading to a reduction of AAF. Inhibition of fibroblastic proliferation has been described as a keystone in the prevention of peritoneal adhesions [3,4]. …”

Section: Discussionmentioning

confidence: 99%

“…3). The presence, extent, severity and degree of intra-abdominal adhesions were evaluated by a gynecologist who was blinded for allocation information and scored according to the Leach scoring system (table 1) [4]. Total adhesion scores (sum of severity, extent and degree scores) were used for comparisons between groups.…”

Section: Methodsmentioning

confidence: 99%

“…Inflammatory mediators like arachidonic acid, cytokines, nitric oxide and oxygen-derived free radicals may contribute to postoperative AAF. Dietary vitamin E, intraperitoneal injection of superoxide dismutase and catalase block the effect of oxygen free radicals and reactive oxygen species, thereby attenuating the inflammatory reaction, which subsequently leads to AAF in an endometriosis animal model [2,3,4]. …”

Section: Introductionmentioning

confidence: 99%

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Effect of Caffeic Acid Phenethyl Ester on Intra-Abdominal Adhesion in Rats

Turgut

Sak

Türkçü³

et al. 2013

Gynecol Obstet Invest

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Background: To determine the impact of caffeic acid phenethyl ester (CAPE) on abdominal adhesion formation after laparotomy. Methods: Forty female rats were allocated into four distinct groups on which laparotomy alone; laparotomy with traumatization of the uterine horns; laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with saline, and laparotomy, traumatization of the uterine horns and intraperitoneal irrigation with CAPE were performed. After sacrifying the animals on the 14th postoperative day, histopathological examination and biochemical analysis were conducted to evaluate the formation of abdominal adhesions and antioxidant status. Results: In the CAPE group, total adhesion scores were significantly lower than in the control and saline groups. The CAPE group displayed less inflammation, giant cell formation, fibrosis and fibroblastic activity than the control group. On the other hand, the control group displayed higher total adhesion scores. Conclusion: The results of this study indicate that the administration of CAPE may have beneficial effects for the prevention of abdominal adhesion formation after laparotomy. Further clinical studies are mandatory to explore the actual therapeutic potential of CAPE.

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Reduction of Postsurgical Adhesion Formation in the Rabbit Uterine Horn Model with Use of Hyaluronate/ Carboxymethylcellulose Gel

Cited by 128 publications

References 14 publications

Cross-Linked Hyaluronic Acid Films to Reduce Intra-Abdominal Postsurgical Adhesions in an Experimental Model

Cross-Linked Hyaluronic Acid Films to Reduce Intra-Abdominal Postsurgical Adhesions in an Experimental Model

Abdominal Adhesion Prevention: Still a Sticky Subject

Effect of Caffeic Acid Phenethyl Ester on Intra-Abdominal Adhesion in Rats

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