Inhibition of adhesion reformation in the rabbit model by meclofenamate: an inhibitor of both prostaglandin and leukotriene production.
OBJECTIVE
To determine the relative ability of meclofenamate sodium, a water-soluble inhibitor of both prostaglandin and leukotriene synthesis, to inhibit adhesion reformation.


METHODS
Prospective, randomized study in a rabbit model.


METHODS
Laparotomies were performed on mature New Zealand White rabbits, and each uterine horn was devascularized and traumatized with unipolar electrocautery. One week later, adhesions were microsurgically lysed. Each rabbit was randomly assigned to one of five different groups, and different solutions or an adhesion barrier were placed into the peritoneal cavities before closure: [1] control, 40 mL of normal saline (n = 8); [2] meclofenamate, 1.75 mg/mL in 40 mL of normal saline (n = 7); [3] Hyskon, 40 mL of 32% dextran-70 (n = 6); [4] meclofenamate 1.75 mg/mL in 40 mL of 32% dextran-70 (n = 6); and [5] TC-7, 40 mL of normal saline plus oxidized regenerated cellulose fabric, Interceed, placed over the site of adhesion lysis (n = 6). Two weeks later, adhesion reformation was scored according to percent involvement of each uterine horn (0 to 4), and adhesion density (0 to 1) and compared using a one-factor analysis of variance.


RESULTS
Adhesion reformation was greatest in the control group (mean score +/- SEM, 3.7 +/- 0.4) and was decreased, but not significantly, in the Hyskon group (2.7 +/- 0.4). Compared with the control group, reformation was significantly decreased in the meclofenamate group (2.3 +/- 0.2), the TC-7 group (2.0 +/- 0.5), and the meclofenamate/Hyskon group (1.1 +/- 0.3). This last group was also decreased compared with the meclofenamate and Hyskon groups.


CONCLUSIONS
Meclofenamate significantly inhibits adhesion reformation in the rabbit model, especially when used in combination with a 32% dextran-70 solution.
Cofer
K F
KF
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor.
Himebaugh
K S
KS
Gauvin
J M
JM
Hurd
W W
WW
D000818:Animals; D005260:Female; D020024:Leukotriene Antagonists; D008469:Meclofenamic Acid / Q000494:pharmacology*; D008866:Microsurgery; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D011448:Prostaglandin Antagonists / Q000494:pharmacology*; D011817:Rabbits; D012008:Recurrence; D000267:Tissue Adhesions / Q000517:prevention & control / Q000601:surgery; D014591:Uterine Diseases / Q000517:prevention & control* / Q000601:surgery
D020024:Leukotriene Antagonists; D011448:Prostaglandin Antagonists; D008469:Meclofenamic Acid