title: Reduction of postoperative adhesions by N,O-carboxymethylchitosan and spermine NONOate in rats.
abstract: BACKGROUND
  Postsurgical adhesions can occur following virtually all types of surgery, resulting in serious clinical complications. Therefore, prevention of adhesions is an important goal of surgical practice. A rat uterine horn model was used to investigate the efficacy of N,O-carboxymethylchitosan (NOCC) and spermine NONOate (SPER/NO) alone and in combination in preventing adhesion formation.
  
  
  METHODS
  Sixty Wistar albino rats underwent bilateral uterine horn injury with a unipolar cautery. Study groups were as follows: (i) control group, no adjuvant therapy; and those with adjuvant applied, (ii) normal saline group, 2 ml of normal saline was given; (iii) NOCC group, 2 ml of 2% NOCC gel was given; (iv) SPER/NO group, 2 ml of SPER/NO (0.5 mg/ml) was given, and (v) NOCC plus SPER/NO group, 2 ml of 2% NOCC gel including SPER/NO (0.5 mg/ml) was given. After 14 days, all animals were euthanatized, and a standard adhesion scoring system including extent and severity scores was applied by a blinded examiner.
  
  
  RESULTS
  The extent score in NOCC plus SPER/NO group was significantly lower than those of control and normal saline groups (p < 0.05). The extent score in NOCC group was significantly lower than that of normal saline group (p < 0.05). The extent score in NOCC plus SPER/NO group was significantly lower than that of SPER/NO group (p < 0.05). The severity score was significantly lower in NOCC plus SPER/NO and NOCC groups than that of control group (p < 0.05). The severity score was significantly lower in NOCC plus SPER/NO group than that of SPER/NO group (p < 0.05).
  
  
  CONCLUSIONS
  Postoperative administration of NOCC gel and SPER/NO alone and especially in combination to the site of peritoneal injury reduces the formation of adhesions in the rat uterine horn model.
authors.affiliation: Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Duran
authors.forename: Dogan
authors.initials: D
authors.lastname: Ak
authors.forename: Ali
authors.initials: A
authors.lastname: Cetin
authors.forename: Tevfik
authors.initials: T
authors.lastname: Guvenal
authors.forename: Meral
authors.initials: M
authors.lastname: Cetin
authors.forename: Ayse Gonca
authors.initials: AG
authors.lastname: Imir
mesh_terms: D000818:Animals; D002686:Chitin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology*; D048271:Chitosan; D005260:Female; D005782:Gels; D009589:Nitrogen Oxides; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013096:Spermine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology*; D000267:Tissue Adhesions / Q000517:prevention & control
chemical_list: D005782:Gels; D009589:Nitrogen Oxides; C077199:O,N-carboxymethylchitosan; C091861:spermine nitric oxide complex; D002686:Chitin; D013096:Spermine; D048271:Chitosan