Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats.
OBJECTIVE
The aim of this study was to evaluate the efficacy of two absorbable film barriers, polylactic acid and sodium hyaluronate-carboxymethyl cellulose, in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model.


METHODS
Forty Wistar albino rats were grouped as polylactic acid, sodium hyaluronate-carboxymethyl cellulose, and control. All rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. The two treatment groups received polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers, while control group received nothing. On postoperative day 21, three observers graded the intra-abdominal adhesions and resected specimens. Fibrosis, inflammation, and adhesions were graded using quantitative scoring systems.


RESULTS
When compared to control group, polylactic acid group showed significantly less inflammation and adhesion (p < 0.005), while there was no significant difference for fibrosis. Sodium hyaluronate-carboxymethyl cellulose group has showed significantly less adhesions (p < 0.005), but there were no significant differences among fibrosis and inflammation when compared to control group. There were no significant differences between polylactic acid and sodium hyaluronate-carboxymethyl cellulose groups on adhesion formation, inflammation, or fibrosis.


CONCLUSIONS
Placement of polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers between injured surfaces is associated with a significantly reduced rate of postoperative adhesions. No superiority was detected between two barriers.
Ersoy
Eren
E
Department of General Surgery, Ataturk Research and Training Hospital, Acar Beytepe Evleri, 154/27, Beytepe, Ankara, Turkey. perenersoy@gmail.com
Ozturk
Vedat
V
Yazgan
Aylin
A
Ozdogan
Mehmet
M
Gundogdu
Haldun
H
D034861:Abdominal Wall / Q000473:pathology* / Q000601:surgery; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D005260:Female; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D019344:Lactic Acid / Q000627:therapeutic use*; D007813:Laparotomy / Q000009:adverse effects*; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers / Q000627:therapeutic use*; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; C118198:Seprafilm; D019344:Lactic Acid; C033616:poly(lactide); D006820:Hyaluronic Acid
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