Prevention of Intra-abdominal Abscesses and Adhesions Using a Hyaluronic Acid Solution in a Rat Peritonitis Model

• Published in: Archives of surgery (Chicago, IL. 1960) Vol. 134; no. 9; pp. 997 - 1001
• Main Authors: Reijnen, Michel M. P. J, Meis, Jacques F. G. M, Postma, Victor A, van Goor, Harry
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL American Medical Association 01.09.1999
• Subjects: Abdomen; Abdominal Abscess - etiology; Abdominal Abscess - prevention & control; Adjuvants, Immunologic - therapeutic use; Animals; Biological and medical sciences; Disease Models, Animal; Gastroenterology. Liver. Pancreas. Abdomen; Hyaluronic Acid - therapeutic use; Male; Medical sciences; Nursing; Other diseases. Semiology; Peritonitis - complications; Random Allocation; Rats; Rats, Wistar; Solutions; Tissue Adhesions - etiology; Tissue Adhesions - prevention & control; Netherlands; Europe; Animal model; Peritoneal adhesion; Rat; Treatment efficiency; Rodentia; Abscess; Abdomen; Infection; Prevention; Vertebrata; Chemotherapy; Mammalia; Treatment; Abdominal disease; Animal; Hyaluronic acid; Peritonitis
• ISSN: 0004-0010; 2168-6254; 1538-3644; 2168-6262
• DOI: 10.1001/archsurg.134.9.997

HYPOTHESIS Hyaluronic acid (HA)–based bioresorbable membrane and 0.4% HA solution reduce intra-abdominal adhesion and abscess formation in a rat peritonitis model. DESIGN Randomized laboratory experiment. SETTING A university hospital. INTERVENTIONS In 72 male Wistar rats, a bacterial peritonitis was induced using the cecal ligation and puncture model. Animals were randomized to receive isotonic sodium chloride solution (group 1), HA-carboxymethylcellulose bioresorbable membrane (group 2), or 0.4% HA solution (group 3). Half of each group were killed at day 7 and half at day 21, and adhesions were scored in a blind fashion. The presence and sizes of intra-abdominal abscesses were noted. Cultures were taken for bacterial analysis. MAIN OUTCOME MEASURES Intra-abdominal adhesions and abscesses. RESULTS The median severity of adhesions was significantly lower in group 3 compared with group 1 rats at day 7 (II [range, I-IV] vs IV [range, I-IV], respectively; P=.02) and at day 21 (II [range, I-III] vs IV [range, II-IV], respectively; P=.02). There was no significant difference between group 2 and group 1 rats on either day. At day 7, abscesses larger than 2 cm were found in 6 of 12 group 1 rats and in 4 of 12 group 2 rats, but in 0 of 11 group 3 rats (P=.01). At day 21, 0 of 11 group 3 rats had an intra-abdominal abscess, in contrast to 4 (33%) of 12 group 1 rats and 5 (45%) of 11 group 2 rats. All cultures of abscesses revealed polymicrobial flora. CONCLUSION Adhesion and abscess formation are reduced using a 0.4% HA solution, and not HA-carboxymethylcellulose bioresorbable membrane, in a rat model of generalized bacterial peritonitis.Arch Surg. 1999;134:997-1001-->