title: Innovative barriers for peritoneal adhesion prevention: liquid or solid? A rat uterine horn model.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany. markus.wallwiener@aesconmed.de
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
authors.forename: Sara
authors.initials: S
authors.lastname: Brucker
authors.forename: Helmut
authors.initials: H
authors.lastname: Hierlemann
authors.forename: Christoph
authors.initials: C
authors.lastname: Brochhausen
authors.forename: Erich
authors.initials: E
authors.lastname: Solomayer
authors.forename: Christian
authors.initials: C
authors.lastname: Wallwiener
mesh_terms: 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
chemical_list: 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)