A novel hyaluronan-based gel in laparoscopic adhesion prevention: preclinical evaluation in an animal model.
OBJECTIVE
To evaluate the effectiveness of a crosslinked hyaluronan solution (ACP gel) in the prevention of postsurgical adhesions in laparoscopic surgery.


METHODS
A randomized blinded study using a rabbit model in laparoscopic surgery.


METHODS
A standardized surgical trauma in the rabbit uterine horn to induce adhesion formation.


METHODS
Sixty-four sexually matured female New Zealand white rabbits weighing 2.5 to 3.0 kg and aged 3-4 months.


METHODS
After trauma, group 1 (n = 22) received no treatment, group 2 animals (n = 20) received oxidized-regenerated cellulose (Interceed [TC7]) in group 3 (n = 22) 5 mL of ACP gel were applied on the lesion.


METHODS
Six weeks after laparoscopy, a laparotomy was performed and the adhesions were scored according to Blauer's scoring system.


RESULTS
66% of the untreated animals and 85% of the animals treated with Interceed presented with severe adhesions, whereas only 35% of the ACP gel treatment group had significant adhesions. The mean ( +/- SEM) increased adhesion score was 2.24 +/- 0.26 in the untreated group, 2.45 +/- 0.22 in the Interceed group, and was 1.25 +/- 0.28 in the ACP gel group.


CONCLUSIONS
This study revealed that ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparoscopic surgery.
De Iaco
P A
PA
S. Orsola Hospital, Department of Obstetrics and Gynecology, University of Bologna, Italy.
Stefanetti
M
M
Pressato
D
D
Piana
S
S
Doná
M
M
Pavesio
A
A
Bovicelli
L
L
D000818:Animals; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D005782:Gels; D006820:Hyaluronic Acid / Q000737:chemistry*; D010535:Laparoscopy / Q000379:methods*; D011817:Rabbits; D011897:Random Allocation; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D014599:Uterus / Q000293:injuries / Q000473:pathology / Q000601:surgery
D005782:Gels; D006820:Hyaluronic Acid