Evaluation of a fibrin preparation containing tranexamic acid (Adhexil) in a rabbit uterine horn model of adhesions with and without bleeding and in a model with two surgical loci.
OBJECTIVE
To compare the efficacy of a fibrin preparation supplemented with tranexamic acid (Adhexil) with that of established devices, and to determine whether its effect is limited to the site of application.


METHODS
Rabbit uterine horns were abraded in nonbleeding and bleeding variants of an established adhesions model. In a separate study, a sidewall excision with approximation of the abraded cecum was added. Animals randomly received Adhexil at both, neither, or either loci.


METHODS
Laboratory study.


METHODS
Seventy-two female New Zealand White rabbits (Oryctolagus cuniculus).


METHODS
Adhexil, Seprafilm or SprayGel and Interceed.


METHODS
The extent of adhesions was evaluated 13 to 16 days after surgery.


RESULTS
Adhexil reduced adhesions (15 +/- 7%; 15 +/- 4%) compared with controls (74 +/- 13%; 78 +/- 9%) in the bleeding and nonbleeding models, respectively. The reductions resulting from the use of Seprafilm (39 +/- 17%; 34 +/- 14%) or SprayGel (61 +/- 18%; 43 +/- 14%) (n = 4) were not statistically significant. In the bleeding model, Interceed (48 +/- 15%) reduced adhesions only modestly.


CONCLUSIONS
In the combined uterine and sidewall model, Adhexil reduced selectively the extent and incidence of adhesions. The absolute and relative performance of Adhexil in an established adhesions model and in the presence of bleeding justifies its further investigation.
Wiseman
David M
DM
Synechion, Inc., PMB 238, 6757 Arapaho, Suite 711, Dallas, Texas, 75248, USA. synechion@aol.com
Meidler
Roberto
R
Lyahovetsky
Yacov
Y
Kurman
Eran
E
Horn
Sara
S
Nur
Israel
I
D000818:Animals; D004195:Disease Models, Animal; D004338:Drug Combinations; D004353:Drug Evaluation, Preclinical / Q000379:methods; D005260:Female; D005337:Fibrin / Q000008:administration & dosage*; D006470:Hemorrhage / Q000473:pathology / Q000517:prevention & control; D006820:Hyaluronic Acid / Q000008:administration & dosage; D019106:Postoperative Hemorrhage / Q000473:pathology / Q000517:prevention & control; D011817:Rabbits; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*; D014148:Tranexamic Acid / Q000008:administration & dosage*; D014592:Uterine Hemorrhage / Q000473:pathology / Q000517:prevention & control*; D014599:Uterus / Q000187:drug effects / Q000473:pathology / Q000601:surgery*
D004338:Drug Combinations; C118198:Seprafilm; D014148:Tranexamic Acid; D005337:Fibrin; D006820:Hyaluronic Acid