title: Efficacy of melatonin and hyaluronate/carboxymethylcellulose membrane in preventing adhesion reformation following adhesiolysis in a rat uterine model.
abstract: OBJECTIVE
  To evaluate the efficacy of hyaluronate/carboxymethylcellulose (HA/CMC) membrane and melatonin separately and in combination in reducing adhesion reformation following adhesiolysis of surgically induced adhesions in a rat uterine horn adhesion model.
  
  
  METHODS
  A randomized, prospective study was carried out in a university animal laboratory. Ninety-eight female Sprague-Dawley albino rats were operated on. Following infliction of standard lesions, all the animals underwent second operations after one week. In all the animals, there were dense and vascular adhesions only between the uterine horns. These adhesions were lysed. Following the completion of adhesiolysis, the animals were randomized before closure of the abdomen to one of four groups (melatonin, HA/CMC membrane, combination of melatonin and HA/CMC membrane, control group). Seven days after the second surgery, the third operations were carried out and adhesions were scored. The main outcome measures were type, tenacity, and extent of adhesions. Total adhesion scores were determined.
  
  
  RESULTS
  Adhesion scores in the melatonin and HA/CMC membrane groups were similar, and significantly lower than those in the control group (P < 0.001). Adhesion scores in the combination group were lower than those in the other three groups (P < 0.001).
  
  
  CONCLUSIONS
  Melatonin and HA/CMC membrane are both effective separately in preventing adhesion reformation following adhesiolysis, but in combination they are significantly more beneficial.
authors.affiliation: Department of Obstetrics and Gynecology, Yeditepe University, Istanbul, Turkey.
authors.forename: Rukset
authors.initials: R
authors.lastname: Attar
authors.forename: Gazi
authors.initials: G
authors.lastname: Yildirim
authors.forename: Banu
authors.initials: B
authors.lastname: Kumbak
authors.forename: Cem
authors.initials: C
authors.lastname: Ficicioglu
authors.forename: Suzi
authors.initials: S
authors.lastname: Demirbag
authors.forename: Narter
authors.initials: N
authors.lastname: Yesildaglar
mesh_terms: D000287:Administration, Topical; D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use*; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008550:Melatonin / Q000008:administration & dosage / Q000627:therapeutic use*; D008567:Membranes, Artificial; D010532:Peritoneal Diseases / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control* / Q000601:surgery; D011446:Prospective Studies; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology / Q000601:surgery*
chemical_list: D016166:Free Radical Scavengers; D008567:Membranes, Artificial; D006820:Hyaluronic Acid; D008550:Melatonin; D002266:Carboxymethylcellulose Sodium