Comparison of Intraperitoneal Honey and Sodium Hyaluronate-Carboxymethylcellulose (Seprafilm™) for the Prevention of Postoperative Intra-Abdominal Adhesions

• Published in: Clinics (São Paulo, Brazil) Vol. 64; no. 4; pp. 363 - 368
• Main Authors: Emre, Arif, Akin, Murat, Isikgonul, Ipek, Yuksel, Osman, Anadol, Ahmet Ziya, Cifter, Cagatay
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España, S.L.U 01.04.2009; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina / USP; Elsevier España
• Subjects: Animals; Apitherapy - methods; Basic Research; Biocompatible Materials - therapeutic use; Cecal abrasion; Cecum - surgery; Disease Models, Animal; Female; Honey; Hyaluronic Acid - therapeutic use; Injections, Intraperitoneal; MEDICINE, GENERAL & INTERNAL; Postoperative intra-abdominal adhesions; Random Allocation; Rat; Rats; Rats, Wistar; Seprafilm; Tissue Adhesions - pathology; Tissue Adhesions - prevention & control; Treatment Outcome; Honey; Cecal abrasion; Rat; Seprafilm; Postoperative intra-abdominal adhesions
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1590/S1807-59322009000400016

Abdominal surgery can lead to postoperative intra-abdominal adhesions (PIAAs) with significant morbidity and mortality. This study compares the use of honey with a standard bioresorbable membrane (Seprafilm™) to prevent the formation of PIAAs in rats. Thirty rats underwent laparotomy, and PIAAs were induced by scraping the cecum. The animals were divided into three groups, each containing ten rats. Group 1 (control) represented the cecal abrasion group, with no intraperitoneal administration of any substance. Group 2 (honey group) underwent cecal abrasion and intraperitoneal administration of honey. Group 3 (Seprafilm™ group) underwent cecal abrasion and intraperitoneal Seprafilm™ application. Group 1 exhibited higher adhesion scores for adhesions between the abdominal wall and the organs. Groups 2 and 3 had decreased adhesive attachments to the intra-abdominal structures. Compared to group 1, the incidence of adhesion formation was lower in both group 2 (p=0.001) and group 3 (p=0.001). The incidence of fibrosis was also lower in group 2 (p=0.016) and group 3 (p=0.063) compared to group 1. There was no significant difference between the histopathological fibrosis scores for the rats in group 2 and those in group 3 (p= 0.688). This study suggests that both honey and Seprafilm™ decrease the incidence of PIAAs in the rat cecal abrasion model. Although the mechanism of action is not clear, intraperitoneal administration of honey reduced PIAAs. The outcome of this study demonstrates that honey is as effective as Seprafilm™ in preventing PIAAs.