Rapamycin and a hyaluronic acid-carboxymethylcellulose membrane did not lead to reduced adhesion formations in a rat abdominal adhesion model.
OBJECTIVE
Rapamycin, an immunosuppressive in transplant surgery, has an additional antiproliferative effect. The aim of this study was to investigate the potential protective effects of rapamycin on postoperative adhesion development.


METHODS
Ten rats per group underwent midline incision laparotomy and adhesion induction including bowel sutures. Therapy groups received daily intraperitoneal rapamycin injections (1.5 mg/kg body weight) for 3 weeks postoperatively. Controls were rats without any postoperative treatment, rats receiving the rapamycin solvent or a hyaluronic acid-carboxymethylcellulose membrane (Seprafilm(™)).


RESULTS
Postoperative rapamycin application led to enhanced adhesion development and there was a higher rate of wound infections. In addition, Seprafilm(™) did not reduce adhesions, in subgroups there were even more.


CONCLUSIONS
Rapamycin is not recommendable for perioperative immunosuppression, it enhances adhesion development and leads to a higher rate of wound infections. Surprisingly, the established Seprafilm(™) membrane led to more adhesions in our experimental setting.
Clinic for Abdominal, Vascular, Thoracic and Transplant Surgery, Chirurgische Klinik II, Leipzig University, Liebigstr. 18, 04103 Leipzig, Germany. arne.dietrich@medizin.uni-leipzig.de
Arne
A
Dietrich
Maria
M
Bouzidi
Thomas
T
Hartwig
Alexander
A
Schütz
Sven
S
Jonas
D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008567:Membranes, Artificial; D051381:Rats; D017207:Rats, Sprague-Dawley; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000209:etiology; D000267:Tissue Adhesions / Q000209:etiology*
D007166:Immunosuppressive Agents; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium; D020123:Sirolimus