An evaluation of low molecular weight heparin and hyperbaric oxygen treatment in the prevention of intra-abdominal adhesions and wound healing.
BACKGROUND
Abdominal surgery can lead to intra-abdominal adhesions with significant morbidity and mortality. To prevent adhesions, an experimental study was planned to designate the effects of low molecular weight (LMW) heparins and hyperbaric oxygen (HBO) therapy both on the formation of adhesions and wound healing.


METHODS
Thirty-eight Wistar albino rats underwent laparotomy to cause intra-abdominal adhesions by mechanical abrasion of the cecum and ethanol application. The rats were divided into 4 groups. In the control group (group 1) no further management was undertaken. Group 2 was treated by Enoxaparine Na, group 3 received HBO therapy, and group 4 was given both enoxaparine Na and HBO treatment.


RESULTS
There was a statistically significant difference between the control and enoxaparine Na groups regarding adhesions. Statistically significant differences were observed between groups 1 and 4 and between groups 1 and 3 regarding the hydroxyproline content of the abdominal wounds. In the pathologic analysis of the abdominal wounds, there was no statistically significant difference between any of the groups, including the control group, regarding inflammation. Statistically significant differences were observed regarding angiogenesis between the control group and groups 3 and 4. There was also a statistically significant difference regarding fibrosis between groups 1 and 4.


CONCLUSIONS
Enoxaparine Na decreased intra-abdominal adhesions, and HBO therapy had no beneficial effect on adhesions. Enoxaparine Na had no harmful effects on wound healing, and HBO therapy increased the process of wound healing.
Arikan
Soykan
S
General Surgery Clinic, Haseki Education and Research Hospital, Istanbul, Turkey. soykanarikan@yahoo.com
Adas
Gokhan
G
Barut
Gul
G
Toklu
Akin Savas
AS
Kocakusak
Ahmet
A
Uzun
Hafize
H
Kemik
Ozgur
O
Daduk
Yildiray
Y
Aydin
Seval
S
Purisa
Sevim
S
D000005:Abdomen / Q000601:surgery; D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000494:pharmacology*; D006931:Hyperbaric Oxygenation; D010532:Peritoneal Diseases / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence; D000267:Tissue Adhesions / Q000517:prevention & control; D014945:Wound Healing
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight