Prevention of postoperative adhesion formation by individual and combined administration of 4 per cent icodextrin and dimetindene maleate

• Published in: British journal of surgery Vol. 96; no. 12; pp. 1476 - 1483
• Main Authors: Tepetes, K., Asprodini, E. K., Christodoulidis, G., Spyridakis, M., Kouvaras, E., Hatzitheofilou, K.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.12.2009; Wiley
• Subjects: Animals; Biological and medical sciences; Dimethindene - administration & dosage; Drug Combinations; Female; General aspects; Glucans - administration & dosage; Glucose - administration & dosage; Medical sciences; Observer Variation; Peritoneal Diseases - prevention & control; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rabbits; Random Allocation; Tissue Adhesions - prevention & control; Human; Postoperative; Dimetindene; Icodextrin; Dextrin; Antihistaminic; Adhesion; Antiallergic; Medicine; Prevention; Treatment; Surgery; Antagonist; H1 Histamine receptor; Polysaccharide; Formation
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.6746

Background: To date, no single method has been successful in eliminating peritoneal adhesion formation after major abdominal surgery. This study evaluated the individual and possible synergistic effect of a local intraperitoneal barrier, 4 per cent icodextrin, and an intravenously administered antihistamine drug, dimetindene maleate, in the prevention of adhesion development following surgical trauma. Methods: De novo experimental adhesions were induced by standardized trauma of the peritoneum and large bowel in 120 New Zealand White rabbits. The animals were randomized into four groups receiving intraperitoneal saline, intraperitoneal 4 per cent icodextrin (60 ml), intravenous dimetindene maleate (0·1 mg/kg) and 4 per cent icodextrin–dimetindene in combination (n = 30 per group). Ten days later, adhesion scores and incidence were assessed by two independent surgeons. and surface area by computer‐aided planimetry. Results: Treatment with either icodextrin or dimetindene maleate significantly reduced adhesion scores and increased the incidence of adhesion‐free animals in an equipotent manner. The effect of combined treatment on severity, incidence and surface area of adhesions was more pronounced than that of each drug administered separately. Conclusion: Combined administration of 4 per cent icodextrin and dimetindene maleate may be used safely and efficaciously to prevent surgically induced adhesions. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Icodextrin and dimetindene maleate safe and efficacious adhesion prevention