title: Postoperative adhesion prevention using a statin-containing cellulose film in an experimental model.
abstract: BACKGROUND
  Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm(®)) in the prevention of postoperative intraperitoneal adhesions in rats.
  
  
  METHODS
  One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm(®) group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation.
  
  
  RESULTS
  All antiadhesive film groups (Seprafilm(®), placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm(®) in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm(®) group, but only one-quarter in the low-dose Statofilm group.
  
  
  CONCLUSIONS
  The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm(®) in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application.
authors.affiliation: Laboratory of Scientific Research and Experimental Surgery, Second Propedeutical Department of Surgery, Medical School, Aristotle University, and Hippokration General Hospital, Thessaloniki, Greece. miltiadislalountas@yahoo.gr
authors.forename: M
authors.initials: M
authors.lastname: Lalountas
authors.forename: K D
authors.initials: KD
authors.lastname: Ballas
authors.forename: A
authors.initials: A
authors.lastname: Michalakis
authors.forename: K
authors.initials: K
authors.lastname: Psarras
authors.forename: C
authors.initials: C
authors.lastname: Asteriou
authors.forename: D E
authors.initials: DE
authors.lastname: Giakoustidis
authors.forename: C
authors.initials: C
authors.lastname: Nikolaidou
authors.forename: I
authors.initials: I
authors.lastname: Venizelos
authors.forename: T E
authors.initials: TE
authors.lastname: Pavlidis
authors.forename: A K
authors.initials: AK
authors.lastname: Sakantamis
mesh_terms: D000818:Animals; D000069059:Atorvastatin; D001672:Biocompatible Materials / Q000008:administration & dosage; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage*; D005355:Fibrosis; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006820:Hyaluronic Acid / Q000494:pharmacology; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D011758:Pyrroles / Q000008:administration & dosage*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
chemical_list: D001672:Biocompatible Materials; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; C118198:Seprafilm; D006820:Hyaluronic Acid; D000069059:Atorvastatin; D002266:Carboxymethylcellulose Sodium