title: Auto-cross-linked hyaluronic acid gel does not reduce intra-abdominal adhesions or abscess formation in a rat model of peritonitis.
abstract: BACKGROUND
  Prevention of adhesion and abscess formation would decrease mortality and morbidity after peritonitis. In this study the effect of a new anti-adhesive, auto-cross-linked hyaluronic acid polysaccharide (ACP) gel, on adhesion and abscess formation was studied in a rat peritonitis model.
  
  
  METHODS
  In experiment 1, bacterial peritonitis was induced in 24 Wistar rats, using a cecal ligation and puncture model. Animals were randomized to receive 4 mL ACP gel (4%) or 4 mL phosphate buffered saline (PBS). After 2 weeks animals were killed and adhesions and abscesses were scored. In experiment 2, 72 rats underwent the same procedure but were randomized to receive 2 mL ACP gel, 4 mL ACP gel, or 4 mL PBS. After 1 and 3 weeks, respectively, half of the animals in each group were killed and adhesions and abscesses were scored.
  
  
  RESULTS
  The median total adhesion score was 12 (range, 3-20) in the ACP group and was 9 (range, 6-12) in the PBS group (not significant) in experiment 1. 91% of rats in the ACP group developed abscesses, versus 90% in the control group. There were no significant differences in abscess size or number of abscesses. In experiment 2, total adhesion scores in the 2 mL ACP group, 4 mL ACP group, and PBS group were 4 (range, 2-20), 6 (range, 1-11), and 6 (range, 1-18), respectively, (not significant) after 1 week and 3.5 (range, 1-8), 5 (range, 2-15), and 4 (range, 0-9), respectively, (not significant) after 3 weeks. All rats in the 2 mL ACP group and the PBS group and 83% of the 4 mL ACP group had developed abscesses after 1 week. After 3 weeks these percentages were 80, 75, and 73, respectively. There were no significant differences in size or number of abscesses between groups both after 1 and 3 weeks.
  
  
  CONCLUSIONS
  ACP does not reduce adhesion and abscess formation in a rat peritonitis model.
authors.affiliation: Radboud University Nijmegen Medical Center, Department of Surgery, Nijmegen, The Netherlands.
authors.forename: Cornelis J J M
authors.initials: CJ
authors.lastname: Sikkink
authors.forename: Ben
authors.initials: B
authors.lastname: de Man
authors.forename: Robert P
authors.initials: RP
authors.lastname: Bleichrodt
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000005:Abdomen; D000038:Abscess / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D000276:Adjuvants, Immunologic / Q000494:pharmacology*; D000818:Animals; D002432:Cecum / Q000382:microbiology; D003432:Cross-Linking Reagents / Q000494:pharmacology; D004195:Disease Models, Animal; D005782:Gels; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000401:mortality; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008026:Ligation; D008297:Male; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000150:complications / Q000401:mortality; D000267:Tissue Adhesions / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D014951:Wounds, Stab
chemical_list: D000276:Adjuvants, Immunologic; D003432:Cross-Linking Reagents; D005782:Gels; D006820:Hyaluronic Acid