Effect of carboxymethylcellulose and hyaluronate solutions on jejunal healing in horses.
OBJECTIVE
To compare a double-layer inverting anastomosis with a single-layer appositional anastomosis, coated with either 1% sodium carboxymethylcellulose (SCMC) or 0.4% sodium hyaluronate (HA) solutions, in the small intestine of horses with respect to anastomotic healing and adhesion formation.


METHODS
18 adult horses.


METHODS
Midline celiotomy and end-to-end jejunal anastomoses were performed. In control group horses (n = 6), a double-layer inverting anastomosis coated with sterile lactated Ringer's solution was performed. In treatment group horses, a single-layer appositional anastomosis was performed that was coated with 1% carboxymethylcellulose solution (SAA + SCMC group horses, 6) or 0.4% hyaluronate solution (SAA + HA group horses, 6). An additional 500 mL of the respective treatment solution was applied to the jejunal serosal surface, and 2 jejunal serosal abrasion sites were created. Horses were euthanatized 10 days after surgery. Anastomoses and abdominal adhesions were evaluated grossly. Anastomotic healing was evaluated on the basis of bursting wall tension.


RESULTS
Bursting wall tension was significantly greater in SAA + SCMC group horses, compared with control group horses. All intestinal segments failed at a point distant to the anastomosis. Significantly fewer adhesions were found at the abrasion sites of SAA + HA group horses, compared with control group horses. No differences were found in adhesion formation at the anastomotic sites among groups.


CONCLUSIONS
Coating a single-layer appositional jejunal anastomosis with SCMC or HA solutions does not adversely affect anastomotic healing. Application of 0.4% HA solution to the serosal surface of the jejunum significantly decreases the incidence of experimentally induced intra-abdominal adhesion formation in horses.
Eggleston
Randy B
RB
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
Mueller
P O Eric
PO
Parviainen
Anna K
AK
Groover
Erin S
ES
D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000379:methods / Q000662:veterinary; D000818:Animals; D001696:Biomechanical Phenomena; D002266:Carboxymethylcellulose Sodium / Q000494:pharmacology*; D006736:Horses; D006820:Hyaluronic Acid / Q000494:pharmacology*; D007583:Jejunum / Q000601:surgery*; D000267:Tissue Adhesions / Q000662:veterinary; D014945:Wound Healing / Q000187:drug effects*
D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium