J Korean Surg Soc.  2010 Oct;79(4):239-245. 10.4174/jkss.2010.79.4.239.

Efficacy of an Injectable Thermosensitive Gel on Postoperative Adhesion in Rat Model

• Ahn HS
• Lee HJ
• Yoo MW
• Jeong SH
• Han TS
• Kim WH
• Song SC
• Yang HK

• KMID: 2145024
• DOI: http://doi.org/10.4174/jkss.2010.79.4.239

Abstract

PURPOSE
For easy application to targeted area or in laparoscopic surgery, proper injectable antiadhesive agents are needed. The efficacy of two injectable antiadhesive agents- the thermosensitive poly (organophosphazene) hydrogel (Gel group) and a mixed solution of hyaluronate and carboxymethyl cellulose (Guardix-sol(R), Hanmi Medicare, Korea; Gd group) were compared with that of a positive control (one established membranous agent [Interceed(R), Johnson & Johnson, USA; IC group]) and negative control (phosphate buffered saline, control group).
METHODS
Eight ischemic buttons were created on both sides of the peritoneum in twenty-four male Sprague Dawley rats. Each of the solutions, or membrane agent was applied before closing of the wound according to groups (six rats per group). Two rats in the IC group were excluded because of death or intraoperative bleeding. Animals were sacrificed at two or four weeks after surgery. The number of adhesion-forming ischemic buttons and the weight gain were analyzed.
RESULTS
The overall number of adhered ischemic buttons were 23 in the control group (n=48), 22 in the Gd group (n=48), 14 in the Gel group (n=48) and 0 in the IC group (n=32). Overall number of adhered ischemic buttons of the Gd group was not significantly different from that of the control group (P=1.000). However that of the Gel group was smaller than that of the control group, although not statistically significant (P=0.093).
CONCLUSION
The Gel group demonstrated some possibility of having an antiadhesive effect, and the Gd group failed to show antiadhesive effect, in contrast to IC group. A large-scale preclinical study is required to verify these findings.

Keyword

Postoperative adhesion; Ischemic button model; Antiadhesive barrier; Thermosensitive polymer

MeSH Terms

Animals
Carboxymethylcellulose Sodium
Hemorrhage
Humans
Hydrogel
Laparoscopy
Male
Medicare
Membranes
Peritoneum
Rats
Rats, Sprague-Dawley
Weight Gain
Carboxymethylcellulose Sodium
Hydrogel

Figure

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  Fig. 1 Creation of the ischemic buttons and treatment of antiadhesive barriers. (A) The ischemic buttons on both sides of the parietal peritoneum by grasping 5 mm of peritoneum with a hemostat and ligating the base of the segment. (B) The ischemic buttons after management of adhesion.

• 

  Fig. 2 Adhesions after 2 and 4 weeks. The arrow indicated the ischemic buttons with attached adhesions.

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  Fig. 3 The histology of adhesion. Masson's trichrome stain (×100) showed loosely arranged collagen fibers of heterogeneous size and dense fibrotic tissue within the same adhesion.

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