Evaluation of Resorbable Materials for Preventing Surgical Adhesion on Rat Experiment

ABSTRACT

PURPOSE: Postsurgical adhesion formation is still a cause of postoperative morbidity because no satisfactory treatment or prophylaxis has yet been developed. Therefore, we have established an animal model for adhesion prevention, and evaluated the toxicity, inflammation and adhesion prevention effect of available water soluble materials as barriers against adhesion formation. METHODS: Four-week old female Sprague-Dawley rats (Sam TacN(SD)BR, Smatako Co., Seoul Korea) were used. The 2 cm2 of cecal serosa and adjacent abdominal wall were abraded with bone burr, and the serosa of the cecum was sutured to the abdominal wall 1 cm apart from the injured site. The denuded cecum was covered with either sodium hyaluronate (HA), sodium alginate (Alg), sodium carboxymethyl cellulose (CMC), polyethylene glycol-polypropylene glycol-polyethylene glycol (PEG-PPG, Poloxamer), or polyethylene glycol (PEG) on both sides, or neither side (control group) and apposed to the abdominal wall. Two weeks after operation, the quality of adhesion was graded using a whole-number system of zero to five. RESULTS: Adhesion grades were highest in the control group (average 4.8), were a little lower in the PEG-PPG (aver. 4.6) and PEG (aver. 4.1) groups, and were significantly lower in the HA (aver. 3.1), Alg (aver. 3.3) and CMC (aver. 3.0) groups (all, P<0.05). However but inflammation was revealed in the Alg and CMC groups. CONCLUSION: In our animal model for adhesion prevention, a fairly good antiadhesion effect was attained with Alg, CMC and HA, whereas inflammation was revealed with Alg and CMC. In conclusion, HA is the best candidate for adhesion prevention.