Comparison of the reduction of postoperative adhesions by two barriers, one solution, and two pharmacologic agents in the rat uterine model.
OBJECTIVE
To evaluate the effects of two barriers, one solution, and two pharmacologic agents, in single or in combined use, for preventing postsurgical adhesion formation in the rat model.


METHODS
A randomized, prospective study to evaluate the ability of leuprolide acetate, oxidized regenerated cellulose, medroxyprogesterone acetate, sodium hyaluronate, sodium hyaluronate/carboxymethyl cellulose, in single or in combined use, for preventing adhesion formation in a rat model.


METHODS
Wistar female rats.


METHODS
University animal laboratory.


METHODS
Intramuscular injection of pharmacologic agents before surgery and intraperitoneal application of barriers and solution at the end of surgery.


METHODS
Two weeks after surgery, a second laparotomy was performed and the extent of adhesion formation was determined.


RESULTS
All the treatment groups had fewer, less severe adhesions when compared with controls. The combination of medroxyprogesterone acetate and oxidized regenerated cellulose did enhance the adhesion-reducing capacity of oxidized regenerated cellulose. The performance of sodium hyaluronate solution for adhesion prevention was statistically significant, when compared with oxidized regenerated cellulose alone, or sodium hyaluronate used with carboxymethyl cellulose film.


CONCLUSIONS
Pharmacologic agents, barriers, or solutions result in significant reduction of postsurgical adhesions. The sodium hyaluronate solution alone and medroxyprogesterone acetate treatment alone had the least adhesion prevention scores. However, neither monotherapy nor combined therapy proved to be significantly more beneficial.
Second Obstetrics and Gynecology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. dr_yoldemir@yahoo.com
Tevfik
T
Yoldemir
Sermet
S
Sagol
Saban
S
Adakan
Kemal
K
Oztekin
Serdar
S
Ozsener
Nedim
N
Karadadas
D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D004195:Disease Models, Animal; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006820:Hyaluronic Acid / Q000627:therapeutic use; D016729:Leuprolide / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008567:Membranes, Artificial; D011183:Postoperative Complications / Q000517:prevention & control*; D045167:Progesterone Congeners / Q000627:therapeutic use; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000517:prevention & control*
D001672:Biocompatible Materials; D002483:Cellulose, Oxidized; D005300:Fertility Agents, Female; C060002:INTERCEED; D008567:Membranes, Artificial; D045167:Progesterone Congeners; C118198:Seprafilm; D006820:Hyaluronic Acid; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide; D002266:Carboxymethylcellulose Sodium