Innovative barriers for peritoneal adhesion prevention: liquid or solid? A rat uterine horn model.
OBJECTIVE
To compare the effects of solid barriers (PDLA membrane and foil, Interceed), innovative barrier solutions (Adept and Hyalobarrier Gel, phospholipid emulsion), and Ringer's lactate solution in preventing postsurgical peritoneal adhesions in the rat.


METHODS
Prospective, randomized experimental study.


METHODS
Rat model in an academic research environment.


METHODS
Female, nonpregnant Wistar rats.


METHODS
Standardized surgical injuries were applied to the parietal and visceral peritoneum and the uterine horns. The barrier agents were applied and the wound was closed. A second-look laparoscopy was performed 31 days after surgery to assess adhesion formation.


METHODS
Severity and extent of adhesion formation assessed using a multidimensional adhesion scoring system.


RESULTS
Significantly fewer postsurgical adhesions were seen after treatment with Adept, Hyalobarrier Gel, Interceed, PDLA membrane, and phospholipid emulsion than after Ringer's lactate solution. Severe, clinically relevant adhesions were not observed after Hyalobarrier Gel and in only one animal after Adept.


CONCLUSIONS
Both solid and liquid barriers can prevent adhesions. Hydroflotation formulas, such as Adept and Hyalobarrier Gel, avoid suture-induced adhesions, are easy to use, and their protective effects are evenly distributed. They are suitable for adhesion prevention after multifocal trauma in rats, and require further testing in the everyday clinical situation.
Wallwiener
Markus
M
Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany. markus.wallwiener@aesconmed.de
Brucker
Sara
S
Hierlemann
Helmut
H
Brochhausen
Christoph
C
Solomayer
Erich
E
Wallwiener
Christian
C
D000818:Animals; D002483:Cellulose, Oxidized; D004655:Emulsions / Q000494:pharmacology; D005260:Female; D005782:Gels / Q000494:pharmacology; D007552:Isotonic Solutions / Q000494:pharmacology; D019344:Lactic Acid; D008567:Membranes, Artificial; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D010537:Peritoneum / Q000187:drug effects; D011091:Polyesters; D011108:Polymers; D019736:Prostheses and Implants; D051381:Rats; D017208:Rats, Wistar; D000077325:Ringer's Lactate; D012720:Severity of Illness Index; D013537:Sutures / Q000009:adverse effects; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D014599:Uterus / Q000187:drug effects
D002483:Cellulose, Oxidized; D004655:Emulsions; D005782:Gels; C060002:INTERCEED; D007552:Isotonic Solutions; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D000077325:Ringer's Lactate; D019344:Lactic Acid; C033616:poly(lactide)