Topical Application of High-Dose Mesna Prevents Adhesion Formation: An Experimental Animal Study.

BACKGROUND: Adhesion formation is a common complication of abdominal surgeries. Mesna is a drug with fibrinolytic properties which has been used in surgical field to facilitate tissue dissection. The aim of this experimental animal study was to investigate the effect of mesna on prevention of intra-abdominal adhesion in rats. MATERIALS AND METHODS: Twenty-eight Wistar albino rats were used in the study. To create abdominal adhesion, cecum was abraded in all rats. No additional surgical procedure was performed other than adhesion in group 1 (only adhesion). In the other groups, rats were treated topically by administering 0.9% saline (group 2), 40 mg/kg mesna (group 3), and 400 mg/kg mesna (group 4). All rats were sacrificed on postoperative 21st day. Histopathological and macroscopic evaluations of adhesion formation were performed. RESULTS: Quantity of adhesion scores (P = 0.022), severity of adhesion scores (P = 0.041), total adhesion scores (P = 0.023), and histopathological adhesion grading scores (P < 0.001) were reduced by 400 mg/kg mesna. CONCLUSIONS: This is the first study for mesna on prevention of abdominal adhesion formation in rats. We concluded that dose-dependent reduction of adhesion was achieved by mesna. With future studies, topical administration of mesna during open abdominal surgeries may be used to prevent adhesion formation.

Fixed Drug Eruption Caused by Mesna / 대한피부과학회지

A fixed drug eruption (FDE) is a cutaneous reaction caused by various drugs. Mesna is used to decrease urotoxic side effect of cyclophosphamide and there have been no previously reported cases in Korea for any adverse reactions to this drug. Herein, we report a case of a FDE caused by mesna. A 34-year-old woman presented with asymptomatic, brownish macules and patches on the face and back for the past 4 months. She had been treated for SLE with monthly pulses of intravenous cyclophosphamide and mesna for 6 months. She had experienced similar episodes after injection of mesna. The skin biopsy specimen taken from her showed vacuolar degeneration of the basal cell layer and perivascular lymphohistiocyte infiltration in the papillary dermis. We performed prick test, scratch patch test, and intradermal test with mesna and confirmed that a FDE was caused by this drug.