title: Prevention of postsurgical adhesions using an ultrapure alginate-based gel.
abstract: BACKGROUND
  Postoperative adhesion formation is a common consequence of abdominal surgery, and constitutes a major source of morbidity and mortality. This study evaluated an ultrapure alginate-based antiadhesive barrier gel.
  
  
  METHODS
  Experiments were performed in a rat model with caecal abrasion and peritoneal side wall excision. The primary endpoint was the incidence of adhesions at 14 days after surgery. In experiment 1 (24 rats), animals treated with alginate gel were compared with controls that had no antiadhesive barrier. In experiment 2 (42 rats), alginate gel was compared with sodium hyaluronate carboxymethyl cellulose (HA/CMC) membrane and with no antiadhesive barrier. To check for any remote action of the gel, in experiment 3 (45 rats) application of alginate gel to the ipsilateral versus contralateral side of injury was compared with no antiadhesive barrier.
  
  
  RESULTS
  In experiment 1, ultrapure alginate gel reduced the incidence of adhesions from eight of 12 in control animals to one in 12 (P = 0·009). Tissue healing assessed by histology was similar in both groups. In experiment 2, ultrapure alginate gel and HA/CMC membrane showed similar antiadhesive effectiveness, reducing the incidence of adhesions from ten of 14 rats in the control group to three of 14 (P = 0·021) and two of 14 (P = 0·006) respectively. In experiment 3, ultrapure alginate gel reduced the incidence of adhesions at the site of direct application (1 of 15) compared with controls (13 of 15; P = 0·001), but not if applied remotely (9 of 15; P = 0·214).
  
  
  CONCLUSIONS
  Ultrapure alginate gel decreased the incidence of postoperative adhesion formation in this rat model.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. a.chaturvedi@chir.umcn.nl
authors.forename: A A
authors.initials: AA
authors.lastname: Chaturvedi
authors.forename: R M L M
authors.initials: RM
authors.lastname: Lomme
authors.forename: T
authors.initials: T
authors.lastname: Hendriks
authors.forename: H
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000464:Alginates / Q000627:therapeutic use*; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002432:Cecum / Q000601:surgery; D005782:Gels; D020723:Glucuronic Acid / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000627:therapeutic use; D008297:Male; D010537:Peritoneum / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013537:Sutures; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000464:Alginates; D001672:Biocompatible Materials; D005782:Gels; D006603:Hexuronic Acids; D020723:Glucuronic Acid