Crystalloid fluid suspension results in decreased adhesion burden when compared to bioresorbable membranes in a rat model - 16/04/19
Abstract |
Introduction |
Adhesion formation represents a major cause of long-term morbidity. Suspension of intra-abdominal contents in fluid medium may effectively prevent adhesion formation. We compare saline hydro-flotation (NS) to hyaluronate bioresorbable membranes (HBM) for adhesion prevention following surgery.
Methods |
Animals were randomized to four groups: sham (no injury, n = 5), control (injury without intervention, n = 5), HBM (n = 20) or 10 cc NS (n = 21). Interventions were administered after standardized surgical trauma to the cecum and abdominal wall. Necropsies at two weeks were completed to compare adhesion burden using a customary scoring algorithm.
Results |
Significant adhesion burden was noted in all rats. HBM sustained a more significant adhesion burden with higher total adhesion scores (HBM = 10 vs NS = 8.1/15, p = 0.02). Gross adhesion scores were lower with NS (5.6/9) compared to HBM (7.1/9, p = 0.01). Neo-vascularity was more common in HBM at 2.6/3 versus 1.9/3 with NS (p = 0.01). Percent of the cecum encased with adhesion was higher with HBM (42%) compared to NS (31%, p = 0.05).
Discussion |
Fluid based anti-adhesion methods should be considered for abdominal adhesion formation prevention.
El texto completo de este artículo está disponible en PDF.Highlights |
• | Post-operative intra-abdominal adhesions remain a common issue with high associated morbidity. |
• | Current membrane-based adhesion barriers have not demonstrated decreased morbidity related to adhesion formation. |
• | In a rat model, saline instillation provides superior adhesion mitigation compared to an adhesion barrier membrane. |
• | Fluid based adhesion prevention has not been adequately pursued for adhesion prevention and should be more actively explored. |
Keywords : Abdominal adhesions, Adhesion prevention, Small bowel obstruction, Hydro-flotation, Adhesion barriers
Esquema
| ☆ | The views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government. |
Vol 217 - N° 5
P. 954-958 - mai 2019 Regresar al número
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