Adhesion prevention comparing liquid and solid barriers in the rabbit uterine horn model.
OBJECTIVE
The purpose of this study was to assess the ability of four different either solid or fluid barriers to reduce adhesions in an established model of gynecological surgery.


METHODS
50 Chinchilla rabbits underwent bilateral deperitonealization and devascularization of the uterine horns (DUH). Afterwards solid membranes of either hyaluronic acid-carboxymethylcellulose (HA-CMC) or lactide-caprolactone-copolymer (LCC) were placed around the injured uterine horns or fluids (icodextrin (ID) or phospholipids (PL)) were intraperitonealy administered. The control group went without protection. After 10 days, adhesions were measured by planimetry.


RESULTS
Phospholipids (median 49.8 mm2) significantly reduced adhesion areas in comparison to all other groups: surgical controls (median 230.6 mm2), HA-CMC (median 194.9 mm2), LCC (median 327.1 mm2), and icodextrin (median 242.1 mm2).


CONCLUSIONS
These results prove the efficacy of phospholipids to reduce primary adhesion formation in the Chinchilla double uterine horn model compared to HA-CMC, LCC and icodextrin. Future clinical studies are recommended.
Müller
Stefan A
SA
Department of Surgery, Medical Faculty, Rhenish-Westphalian Technical University, Aachen, Germany. sa.mueller@chir.rwth-aachen.de
Treutner
Karl H
KH
Jörn
Hendrik
H
Anurov
Michail
M
Oettinger
Alexander P
AP
Schumpelick
Volker
V
D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage; D005260:Female; D005936:Glucans / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006820:Hyaluronic Acid / Q000008:administration & dosage; D000077607:Icodextrin; D023421:Models, Animal; D010743:Phospholipids / Q000008:administration & dosage*; D011091:Polyesters / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D012996:Solutions; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*; D014599:Uterus / Q000601:surgery*
D005936:Glucans; D010743:Phospholipids; D011091:Polyesters; D012996:Solutions; D000077607:Icodextrin; C062968:lactide-caprolactone copolymer; D006820:Hyaluronic Acid; D005947:Glucose; D002266:Carboxymethylcellulose Sodium