title: Prevention of intra-abdominal abscesses and adhesions using a hyaluronic acid solution in a rat peritonitis model.
abstract: 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.
authors.affiliation: Department of Surgery, University Hospital Nijmegen, The Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: Reijnen
authors.forename: J F
authors.initials: JF
authors.lastname: Meis
authors.forename: V A
authors.initials: VA
authors.lastname: Postma
authors.forename: H
authors.initials: H
authors.lastname: van Goor
mesh_terms: 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
chemical_list: D000276:Adjuvants, Immunologic; D012996:Solutions; D006820:Hyaluronic Acid