Prevention of intra-abdominal abscesses and adhesions using a hyaluronic acid solution in a rat peritonitis model.
OBJECTIVE
Hyaluronic acid (HA)-based bioresorbable membrane and 0.4% HA solution reduce intraabdominal adhesion and abscess formation in a rat peritonitis model.


METHODS
Randomized laboratory experiment.


METHODS
A university hospital.


METHODS
In 72 male Wistar rats, a bacterial peritonitis was induced using the cecal ligation and puncture model. Animals were randomized to receive isotonic sodium chloride solution (group 1), HA-carboxymethylcellulose bioresorbable membrane (group 2), or 0.4% HA solution (group 3). Half of each group were killed at day 7 and half at day 21, and adhesions were scored in a blind fashion. The presence and sizes of intra-abdominal abscesses were noted. Cultures were taken for bacterial analysis.


METHODS
Intra-abdominal adhesions and abscesses.


RESULTS
The median severity of adhesions was significantly lower in group 3 compared with group 1 rats at day 7 (II [range, I-IV] vs IV [range, I-IV], respectively; P=.02) and at day 21 (II [range, I-III vs IV [range, II-IV], respectively; P=.02). There was no significant difference between group 2 and group 1 rats on either day. At day 7, abscesses larger than 2 cm were found in 6 of 12 group 1 rats and in 4 of 12 group 2 rats, but in 0 of 11 group 3 rats (P=.01). At day 21, 0 of 11 group 3 rats had an intra-abdominal abscess, in contrast to 4 (33%) of 12 group 1 rats and 5 (45%) of 11 group 2 rats. All cultures of abscesses revealed polymicrobial flora.


CONCLUSIONS
Adhesion and abscess formation are reduced using a 0.4% HA solution, and not HA-carboxymethylcellulose bioresorbable membrane, in a rat model of generalized bacterial peritonitis.
Reijnen
M M
MM
Department of Surgery, University Hospital Nijmegen, The Netherlands.
Meis
J F
JF
Postma
V A
VA
van Goor
H
H
D018784:Abdominal Abscess / Q000209:etiology / Q000517:prevention & control*; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000818:Animals; D004195:Disease Models, Animal; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D010538:Peritonitis / Q000150:complications*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012996:Solutions; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control
D000276:Adjuvants, Immunologic; D012996:Solutions; D006820:Hyaluronic Acid