Effects of seprafilm and heparin in combination on intra-abdominal adhesions.
OBJECTIVE
Postoperative intra-abdominal adhesion formation is a significant cause of morbidity. The aim of this study was to assess the effects of heparin and Seprafilm, which is considered the gold standard, on the prevention of intra-abdominal adhesions.


METHODS
Four groups consisting of 25 rats each were formed. Cecal abrasion was performed in all animals. Group 1 was the control group with no treatment; in group 2, heparin was applied intraperitoneally; in group 3, Seprafilm was used underneath the abdominal wall, and group 4 animals were treated with both heparin and Seprafilm. Two weeks after the surgical procedure, animals were sacrificed and specimens were removed for the measurement of the grade of adhesions, according to the Mazuji classification.


RESULTS
Formation of adhesions was prevented in the three study groups treated with heparin only, Seprafilm only and both heparin and Seprafilm (p < 0.001) compared with the control group. There was no statistical difference between the treatment groups. Autopsy results of the animals that died within the first week after the surgical procedure revealed intra-abdominal abscess formation and infections, which were considered as possible causes of death.


CONCLUSIONS
Seprafilm seems to be more effective in the prevention of adhesions. In the combined application of Seprafilm and heparin, heparin showed no additive impact. Future studies are needed to detect the suitable dose and side effects of heparin for humans.
Kaptanoglu
L
L
Kartal Research and Education Hospital, Istanbul, Turkey.
Kucuk
H F
HF
Yegenoglu
A
A
Uzun
H
H
Eser
M
M
Mentes
C V
CV
Kurt
N
N
D000005:Abdomen / Q000473:pathology / Q000601:surgery; D034861:Abdominal Wall / Q000473:pathology; D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology*; D002432:Cecum / Q000473:pathology; D004359:Drug Therapy, Combination; D006493:Heparin / Q000494:pharmacology*; D006820:Hyaluronic Acid / Q000494:pharmacology*; D007274:Injections, Intraperitoneal; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D051381:Rats; D000267:Tissue Adhesions / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control*
D000925:Anticoagulants; C118198:Seprafilm; D006820:Hyaluronic Acid; D006493:Heparin