Effects of Three Different Types of Anti-adhesive Agents in a Rat Abdominal Wall Defect Model

ABSTRACT

PURPOSE: Postsurgical adhesion formation is a significant clinical problem within every surgical specialty. Several adhesion barriers have been developed in the form of solution, membrane or film in an attempt to solve these problems. The purpose of the present study is to compare the efficacy of antiadhesive agents in the prevention of postsurgical adhesion formation in a standardized rat adhesion model. METHODS: We examined forty Sprague-Dawley rats, which is a cecal abrasion with partial peritonectomy model. Three treatment groups (Group I Film-type Surgiwrap(R), Group II Solution-type Guardix-sol(R), Group III Membrane-type Interceed(R)), each consists of 10 rats, and a control group of 10 rats were used by saline. Ten days after surgery, the rats were killed, and the levels of adhesion were graded. Immunohistochemical staining for microvessel density (CD34, MVD) and macrophage (ED1) were performed in adhesion tissue. RESULTS: The peritoneum adhesion mean scores are as follows control group 2.2+/-0.78, Group I 1.0+/-1.06, Group II 0.9+/-0.99, Group III 0.6+/-0.84. All treatment groups showed significantly less peritoneum adhesion (P=0.006), while there was no significant difference in each group. The intraperitoneal organs adhesion mean scores are as follows control group 2.8+/-0.91, Group I 2.6+/-1.06, Group II 1.4+/-0.84, Group III 1.0+/-0.81. Group I had no significant difference about intraperitoneal organs adhesion with control group, but Group II and Group III showed less intraperitoneal organs adhesion. The mean numbers of microvessel density are as follows control group 42.5+/-4.83, Group I 40.8+/-6.53, Group II 30.9+/-6.15, Group III 15.60+/-4.37, from which there was a significant difference between Group II and Group III with control group (P<0.001). The mean numbers of macrophage are as follows control group 223.3+/-33.12, Group I 211.25+/-10.96, Group II 171.60+/-23.96, Group III 147.0+/-12.22, from which there was a significant difference between Group II and Group III with control group (P<0.001). CONCLUSION: In our animal model, three different types of antiadhesive agents (Surgiwrap(R), Guardix-sol(R), Interceed(R)) were effective in adhesion prevention, but Surgiwrap(R) had less antiadhesive effect for intraperitoneal organs adhesion. Membrane-type Interceed(R) had a better effect for microvessel density (MVD) and macrophage than solution-type Guardix-sol(R).