title: Biochemical evaluation of postsurgical wound repair: prevention of intraperitoneal adhesion formation with ibuprofen.
abstract: Proteins central to normal wound repair, including collagen and proteoglycans, were extracted during postoperative mesothelial regeneration, then the quantitation was correlated to macroscopic observations of normal peritoneal reepithelialization and/or postoperative adhesion formation. Sixty-three New Zealand white female rabbits of reproductive age were prospectively assigned to either Group A, untreated control; Group B, which received intramuscular injections of ibuprofen, 70 mg/kg per injection (immediately and 6 hr after surgery); or Group C, which received 5 intramuscular injections of ibuprofen (4 hr before surgery, and immediately, 6, 12, and 18 hr after surgery). The right uterine horn underwent one of three standardized surgical traumas: (1) abrasion of the peritoneal surface with a scalpel until punctate bleeding developed, (2) ischemia of the uterine horn by removal of the collateral blood supply (devascularization), (3) crushing of the uterine horn by cross clamping for 3 min with a Kelley hemostat. Thereafter, 10 microCi of C-14-labeled glucosamine and 10 microCi of C-14-labeled proline were injected into the marginal ear vein of each rabbit. All rabbits underwent a laparotomy on the fifth postoperative day for evaluation of adhesion formation and tissue biopsy for protein extraction. No reduction in adhesion formation was found using a 2-dose postoperative treatment regimen. However, using a 70 mg/kg X 5-doses regimen in the immediate perioperative interval, a significant reduction in both adhesion formation and severe adhesion formation (both P less than 0.025) were found following standardized surgical injury. The extent of adhesion formation was correlated with the extractable glycosaminoglycan and collagen concentrations. As determined by recovered glucosamine and proline, a positive correlation was apparent between the severity of adhesion grade and formation of new glycosaminoglycans or collagens. Thus, ibuprofen appears to inhibit adhesion formation through suppression of fibroproliferative inflammation.
mesh_terms: D000818:Animals; D003094:Collagen / Q000096:biosynthesis; D005260:Female; D006025:Glycosaminoglycans / Q000096:biosynthesis; D007052:Ibuprofen / Q000627:therapeutic use*; D010537:Peritoneum / Q000502:physiology / Q000601:surgery*; D011446:Prospective Studies; D011817:Rabbits; D000267:Tissue Adhesions / Q000517:prevention & control*; D014945:Wound Healing
chemical_list: D006025:Glycosaminoglycans; D003094:Collagen; D007052:Ibuprofen