title: Preventing intra-abdominal adhesions with a sodium hyaluronate carboxymethylcellulose membrane enabled visualization of hepatic microcirculation.
abstract: We aimed to evaluate whether using sodium hyaluronate carboxymethylcellulose membrane (Seprafilm™) can facilitate assessment of hepatic microcirculation via orthogonal polarization spectroscopy (OPS) by preventing intra-abdominal adhesions and whether Seprafilm™ as a foreign material can evoke local or systemic inflammatory reactions. After the right median hepatic vein was ligated, rats received either placement of Seprafilm™ or untreated with observation of 1 or 4 weeks (n = 6/group). Hepatic microcirculation was visualized. Systemic and local inflammatory reactions were evaluated by blood count, histology and immunohistochemical staining for CD68. Seprafilm™ significantly (P < 0.05) prevented intra-abdominal adhesion formation compared to non-Seprafilm™ groups (adhesion score: 0 vs 1.3 ± 0.5 at POW1 and 0.3 ± 0.5 vs 3.5 ± 1.4 at POW4). Placement of Seprafilm™ provided sufficient liver surface for acquisition of OPS videos during the harvest procedure. Adhesiolysis in non-Seprafilm™ groups prevented visualization of hepatic microcirculation. A severe local foreign body reaction with formation of a "fibrin-like" membrane containing CD68-positive inflammatory histiocytic cells and mesothelial cells was observed in Seprafilm™ groups even at POW4. Use of Seprafilm™ conferred visualization of hepatic microcirculation after long term observation in experimental setting. In clinical situation, we would suggest being very cautious in immuno-compromised patients because of an ongoing local foreign body reaction caused by Seprafilm™.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Germany.
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.forename: Meihong
authors.initials: M
authors.lastname: Deng
authors.forename: Hao
authors.initials: H
authors.lastname: Jin
authors.forename: Olaf
authors.initials: O
authors.lastname: Dirsch
authors.forename: Uta
authors.initials: U
authors.lastname: Dahmen
mesh_terms: D000818:Animals; D002266:Carboxymethylcellulose Sodium; D006820:Hyaluronic Acid; D007249:Inflammation; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008567:Membranes, Artificial; D008833:Microcirculation / Q000502:physiology*; D018715:Microscopy, Video / Q000379:methods; D011183:Postoperative Complications / Q000473:pathology; D051381:Rats; D011917:Rats, Inbred Lew; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
chemical_list: D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium
keywords: Hepatic microcirculation; Intra-abdominal adhesions; Seprafilm™; Sodium hyaluronate carboxymethylcellulose; Visualization