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Inflammation

, Volume 30, Issue 6, pp 244–249 | Cite as

The Effects of Anti-Adhesion Materials in Preventing Postoperative Adhesion in Abdominal Cavity (Anti-Adhesion Materials for Postoperative Adhesions)

  • Mustafa Sahin
  • Murat Cakir
  • Fatih Mehmet Avsar
  • Ahmet Tekin
  • Tevfik Kucukkartallar
  • Mehmet Akoz
Article

Abstract

Purpose

The purpose of this study was to compare the effects of anti-adhesion materials in postoperative adhesions.

Materials and Methods

Rats were assigned to five groups: Group 1: Control. Group 2: chitin layers were used. Group 3: Na-hyaluronate / carboxymethylcellulose layers were used. Group 4: Na-hyaluronate gel was poured into the abdomen. Group 5: methylprednisolone was injected. The adhesion frequency and grade were scored according to Granat. Blood was taken for Hb, AST, BUN and albumin levels determination.

Findings

The adhesion frequencies (right and left) and grades were as follow in Groups; I: 82%, 91%, 2.63 ± 1.22; II: 8.3%, 25%, 0.58 ± 0.66; III: 17%, 33%, 1.08 ± 1.08; IV: 50%, 58%, 1.41 ± 1.44; V: 50%, 42%, 1.41 ± 1.50. The adhesion phase in all study groups was found significantly low compared to control group, p < 0.05. No difference was observed among serologic and hematological parameters in all groups.

Conclusion

All the materials used significantly lowered the adhesion frequency and grade.

Key words

postoperative adhesion anti-adhesion materials abdominal cavity 

References

  1. 1.
    Ellis, H. 1978. Wound repair-reaction of the peritoneum to injury. Ann. R. Coll. Surg. 60:219–221.Google Scholar
  2. 2.
    Sahin, M., B. Gürocak, S. Tavlı, et al. Effects of different doses of stefsroid in the prevention of intra-abdominal adhesions. Int. J. Surg. Investig. 3:301–306.Google Scholar
  3. 3.
    Kazman, S. H., M. Belviranl, M. ahin, et al. 1997. Mekanik intestinal obstrüksiyona bal opere edilmi hastalarn klinik analizi. T. Klin. 17:203–209.Google Scholar
  4. 4.
    Lehr, C.-M., J. A. Bouwstra, E. H. Schacht, et al. 1992. In vitro evaluation of mucoadhesive properties of chitosan and some other natural polymers. Int. J. Pharm. 78:43–44.CrossRefGoogle Scholar
  5. 5.
    Obara, K., M. Ishihara, T. Ishizuka, et al. 2003. Photocrosslinkable chitosan hydrogel containing fibroblast growth factor-2 stimulates wound healing in healing-impaired db/db mice. Biomaterials 24:3437–3444.PubMedCrossRefGoogle Scholar
  6. 6.
    Granat, M., I. Tur-Kapsa, E. Zylber-Katz, et al. 1983. Reduction of peritoneal adhesion formation by colchicine: a comparative study in the rat. Fertil. Steril. 40:369–372.PubMedGoogle Scholar
  7. 7.
    Stewardson, R. H., C. T. Bombeck, and L. M. Nyhus. 1978. Critical operative management of small bowel obstruction. Ann. Surg. 187:189–193.PubMedCrossRefGoogle Scholar
  8. 8.
    Raf, L. E. 1969. Causes of abdominal adhesions in cases of intestinal obstructions. Acta Chir. Scand. 135:75–76.Google Scholar
  9. 9.
    Sannella, N. A. 1975. Early and late obstruction of the small bowel after abdominoperineal resection. Am. J. Surg. 130:270–272.PubMedCrossRefGoogle Scholar
  10. 10.
    Raf, L. E. 1969. Causes of small intestinal obstruction. A study covering the Stockholm area. Acta Chir. Scand. 135:67–72.PubMedGoogle Scholar
  11. 11.
    Özer, . B., E. Kaymak, et al. 1990. Peritonun yaralanmaya kar reaksiyonu ve periton içi yapklk problemi (In Turkish). zmir Devlet Hastanesi Tp Dergisi 28:237–243.Google Scholar
  12. 12.
    Gazzaniga, A. B., J. M. James, J. B. Shobe, et al. 1975. Prevention of peritoneal adhesions in the rat. The effects of dexamethasone, methylprednisone, promethazine and human fibrinolysin. Arch. Surg. 110:429–432.PubMedGoogle Scholar
  13. 13.
    Milligan, D. W., and A. T. Raftery. 1974. Observations on the pathogenesis of peritoneal adhesions: a light and electron microscopical study. Br. J. Surg. 61:274–280.PubMedCrossRefGoogle Scholar
  14. 14.
    Vural, B., N. Z. Cantürk, N. Esen, et al. 1999. The role of neutrophils in the formation of peritoneal adhesions. Hum. Reprod. 14:49–54.PubMedCrossRefGoogle Scholar
  15. 15.
    Le Grand, E. K., K. E. Rodgers, W. Girgis, et al. 1995. Comparative efficacy of nonsteroidal anti-inflammatory drugs and ani-thromboxane agents in a rabbit adhesion-prevention model. J. Invest. Surg. 830:187–191.Google Scholar
  16. 16.
    VandeVord, P. J., H. W. T. Matthew, S. P. DeSilva, et al. 2002. Evaluation of the biocompatibility of a chitosan scaffold in mice. J. Biomed. Mater. Res. 59:585–590.PubMedCrossRefGoogle Scholar
  17. 17.
    Nordtveit, R. J., K. M. Varum, and O. Smidsrød. 1996. Degradation of partially N-acetylated chitosans with hen egg white and human lysozyme. Carbohydr. Polym. 29:163–167.CrossRefGoogle Scholar
  18. 18.
    Varurn, K. M., M. M. Myhr, R. J. N. Hjerde, et al. 1997. In vitro degradation rates of partially N-acetylated chitosans in human serum. Carbohydr. Res. 299:99–101.CrossRefGoogle Scholar
  19. 19.
    Tomihata, K., and Y. Ikada. 1997. In vitro and in vivo degradation of films of chitin and its deacetylated derivatives. Biomaterials 18:567–575.PubMedCrossRefGoogle Scholar
  20. 20.
    Dargenio, R., Cimino, C., Ragusa, G., et al. 1986. Pharmacological prevention of postoperative adhesions experimentally induced in the rat. Actu. Eur. Fertil. 17:272–276.Google Scholar
  21. 21.
    Diamond, M. P., and A. H. DeCherney. 1987. Pathogenesis of adhesion formation/reformation; application to reproduce pelvic surgery. Microsurgery 8:101–107.Google Scholar
  22. 22.
    Kappas, A. M., G. H. Barsoum, J. B. Ortiz, et al. 1992. Prevention of peritoneal adhesions in rats with verapamil, hydrocortisone sodium succinate and phosphatidylcholine. Eur. J. Surg. 158:33–35.PubMedGoogle Scholar
  23. 23.
    Cohen, B. M., T. Heyman, and T. Mast, 1983. Use of intraperitoneal solutions for preventing pelvic adhesions in the rat. J. Reprod. Med. 28:649–653.PubMedGoogle Scholar
  24. 24.
    Christin, D., and P. Buchmann. 1991. Peritoneal adhesions after laparotomy: prophylactic measures. Hepato-Gastroenterol. 38:283–286.Google Scholar
  25. 25.
    Reijnen, M. M., P. Falk, H. van Goor, et al. 2000. The antiadhesive agent sodium hyaluronate increases the proliferation rate of human peritoneal mesothelial cells. Fertil. Steril. 74:146–151.PubMedCrossRefGoogle Scholar
  26. 26.
    Laurent, T.C., U.B. Laurent, and J.R. Fraser. 1996. The structure and function of hyaluronan: an overview. Immunol. Cell Biol. 74:1–7.CrossRefGoogle Scholar
  27. 27.
    Adams, M. E., A. J. Lussier, and J. G. Peyron. 2000. A risk–benefit assessment of injections of hyaluronan and its derivatives in the treatment of osteoarthritis of the knee. Drug Safety 23:115–130.PubMedCrossRefGoogle Scholar
  28. 28.
    Balazs, E. A., and J. L. Denlinger. 1993. Viscosupplementation: a new concept in the treatment of osteoarthritis. J. Rheumatol. Suppl. 39:3–9.PubMedGoogle Scholar
  29. 29.
    Takeuchi, H., H. Yamamoto, T. Niwa, et al. 1994. Mucoadhesion of polymer-coated liposomes to rat intestine in vitro. Chem. Pharm. Bull. (Tokyo) 42(9):1954–1956.Google Scholar
  30. 30.
    Bol’shakov, I. N., S. M. Nasibov, D. B. Kulaev, et al. 1994. Use of liquid sorbents based on chitosan for treatment of diffuse forms of peritonitis. Patol. Fiziol. Eksp. Ter. 3:49–50.PubMedGoogle Scholar
  31. 31.
    Biagini, G. 1991. Wound management with N-carboxy butyl chitosan. Biomaterials 12:28–31.Google Scholar
  32. 32.
    Weibel, and G. Majno. 1973. Peritoneal adhesions and their relation to abdominal surgery. A postmortem study. Am. J. Surg. 126:345–353.PubMedCrossRefGoogle Scholar
  33. 33.
    Moreno, A., J. L. Aguayo, G. Zambudio, et al. 1996. Influence of abdominal incision on the formation of postoperative peritoneal adhesions: an experimental study in rats. Eur. J. Surg. 162:181–185.PubMedGoogle Scholar
  34. 34.
    Avsar, F. M., M. ahin, H. Özel, et al. 2001. Effects of hyaluronic acid derivatives on the postoperative peritoneal adhesions. Int. J. Surg. Investig. 3:437–442.Google Scholar
  35. 35.
    Avsar, F. M., M. Sahin, F. Aksoy, et al. 2001. Effects of diphenhydramine HCL and methylprednisolone in the prevention of abdominal adhesions. Am. J. Surg. 181:512–515.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Mustafa Sahin
    • 1
  • Murat Cakir
    • 1
  • Fatih Mehmet Avsar
    • 2
  • Ahmet Tekin
    • 1
    • 4
  • Tevfik Kucukkartallar
    • 1
  • Mehmet Akoz
    • 3
  1. 1.Department of General SurgerySelcuk University Meram Medical FacultyKonyaTurkey
  2. 2.Department of Surgical Emergency ServiceAnkara Numune Training and Research HospitalAnkaraTurkey
  3. 3.Department of BiochemistrySelcuk University Meram Medical FacultyKonyaTurkey
  4. 4.KonyaTurkey

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