Comparison of the resorbable barrier interceed (TC7) and preoperative use of medroxyprogesterone acetate in postoperative adhesion prevention.
OBJECTIVE
The purpose of this study was to compare the effectiveness of barrier agent Interceed (TC7) (Johnson & Johnson Medical, Inc) and preoperative use of commonly used progesterone, medroxyprogesterone acetate.


METHODS
Forty-five Spraque-Dawley white rats of reproductive age (225-250 g) were employed as a model for postsurgical adhesion formation. Group 1 consisted of control rats, Group 2 consisted only of rats with Interceed applied to the denuded areas, Group 3 consisted of rats where preoperative MPA was used. Fifteen rats were exposed to daily IM injections of 15 mg medroxyprogesterone acetate (MPA) two weeks before the surgery.


RESULTS
The total adhesion score of the MPA group was significantly less than the control and Interceed group respectively (chi2=10.15) (p<0.001), (chi2=4.67) (p<0.03). There was no significant difference between the Interceed and the control group (p>0.05).


CONCLUSIONS
Preoperative long-term MPA treatment significantly decreases primary adhesion formation. It seems that there are some other mechanisms responsible for this effect rather than anti-inflammation and/or immunosuppression. It may be that the hypoestrogenic milieu depends on the use of progesterone.
Baysal
B
B
University of Istanbul, Istanbul Medical School Hospital, Capa, Turkey.
D000005:Abdomen / Q000601:surgery; D000818:Animals; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D005260:Female; D007813:Laparotomy / Q000009:adverse effects; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D010532:Peritoneal Diseases / Q000517:prevention & control*; D045167:Progesterone Congeners / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions; D014599:Uterus / Q000601:surgery; D014945:Wound Healing
D002483:Cellulose, Oxidized; C060002:INTERCEED; D045167:Progesterone Congeners; D008525:Medroxyprogesterone