Hyaluronic acid-carboxymethylcellulose film and perianastomotic adhesions in previously irradiated rats.
OBJECTIVE
Postoperative intra-abdominal adhesions are a major source of postsurgical morbidity. Pelvic irradiation increases the likelihood of adhesion development. The purpose of this study was to evaluate the effects of hyaluronic acid-carboxymethylcellulose film, which was designed as a barrier to prevent adhesions, on the healing of ileal anastomoses performed on irradiated rat bowel.


METHODS
Sixty-eight female Sprague-Dawley rats underwent whole pelvic irradiation with a single fraction of 1700 cGy. Twenty weeks later the rats underwent exploratory laparotomy with segmental ileal resection and reanastomosis. Eighteen of the anastomoses were wrapped in hyaluronic acid-carboxymethylcellulose film. Fifty anastomoses were not treated with any adhesion-inhibiting barrier. On the fifth postoperative day the animals underwent another laparotomy for evaluation of the anastomotic sites.


RESULTS
At the second laparotomy 93% of the rats treated with hyaluronic acid-carboxymethylcellulose film were found to have perianastomotic abscesses. In the non-hyaluronic acid-carboxymethylcellulose film group the perianastomotic abscess rate was 24% (P <.0001).


CONCLUSIONS
Among previously irradiated rats undergoing small-bowel resection and anastomosis, hyaluronic acid-carboxymethylcellulose film was associated with a markedly increased rate of abscess formation at the operative site.
Bowers
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Institute for Special Pelvic Surgery, Department of Obstetrics and Gynecology, Sinai Hospital of Baltimore, Maryland 21215, USA.
Raybon
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RB
Wheeless
C R
CR
D000038:Abscess / Q000209:etiology*; D000714:Anastomosis, Surgical; D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects / Q000627:therapeutic use; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects* / Q000627:therapeutic use; D004195:Disease Models, Animal; D005260:Female; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D007082:Ileum / Q000293:injuries / Q000601:surgery*; D008567:Membranes, Artificial; D011833:Radiation Injuries, Experimental / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000517:prevention & control*; D014945:Wound Healing
D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium