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The effect of hyaluronan-based agents on adhesion formation in an intraabdominal sepsis model.

Abstract：

:Because of the technical difficulty during subsequent surgical intervention, adhesion remains the most important predictor of outcome in the staged procedures following emergent colorectal surgery. The aim of this study was to assess the long-term effects of hyaluronan (HA)-based adhesion barriers 3 months following the infectious insult to the peritoneal cavity. Wistar albino rats were divided into three sham and four infectious groups, each consisting of 20 rats. Sham groups consisted of a control group (I), which had undergone manipulation of the cecum in the first operation and saline irrigation following the cecal resection in the second operation; an HA-based bioresorbable membrane (BM) group (II), in which 20 x 20- and 35 x 25-mm pieces of HA-based bioresorbable membrane were placed over the cecectomy area and under the midline incision, respectively, with other conditions the same as for the control (I) group; and an HA-based solution (S) group (II), where HA solution was used as an irrigation solution, with other conditions the same as for the control group (I). Infectious groups consisted of a septic group (IV), which had undergone cecal ligation and puncture in the first operation and saline irrigation following the cecal resection in the second operation; a sepsis + HA-BM group (V), in which two sheets of membrane were applied, with other conditions the same as for the septic group (IV); a sepsis + HA-S group (VI), in which HA solution was used as an irrigation solution, with conditions otherwise the same as for the septic group (IV); and a sepsis + HA-BM + HA-S group (VII), where HA solution was used as an irrigation solution and two sheets of membrane were applied, with other conditions the same as for the septic group (IV). At the end of the 3-month period, mortality, septic complications, and intraabdominal adhesions (adhesion scores and adhesion tensile strength measurements) were recorded. Significantly denser adhesions were found in the septic group (IV) when compared to the others (P < 0.001). HA-S significantly reduced not only the incidence of adhesion but also the adhesion tensile strength in infectious groups (P < 0.001 compared to the sepsis group). However, HA-BM significantly reduced adhesion tensile strength only. Irrigation of the peritoneal cavity with HA-S may prove to be useful to shorten the reversal time period and decrease morbidity following staged procedures for intraabdominal sepsis.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Tüzüner A,Kuzu MA,Akin B,Karaca S,Hazinedaroglu S

doi

10.1023/b:ddas.0000034571.30602.36

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

1054-61

issue

eissn

0163-2116

issn

1573-2568

journal_volume

pub_type

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The effect of hyaluronan-based agents on adhesion formation in an intraabdominal sepsis model.