title: Ultrapure alginate gel reduces adhesion reformation after adhesiolysis.
abstract: OBJECTIVE
  Adhesiolysis at repeat surgery induces adhesion reformation which seems more virulent than development of de novo adhesions. We studied the effect of a new ultrapure alginate gel on adhesion reformation.
  
  
  METHODS
  In 46 male Wistar rats, adhesion formation was induced using the cecal abrasion and peritoneal sidewall excision procedure. Two weeks later, a second laparotomy was performed, adhesions were graded, and surgical adhesiolysis was performed. The animals were then allocated to one of two equal groups, a control group without further intervention and a group receiving 1-ml ultrapure alginate gel to the two opposing and damaged surfaces. Two weeks after the second surgery, rats were sacrificed. Primary endpoint was the incidence of adhesion reformation at areas of injury. Secondary endpoints were adhesion scores, extent of adhesions, and tissue histology.
  
  
  RESULTS
  Ultrapure alginate gel significantly (p = 0.046) reduced the incidence of adhesion reformation from 100 % in controls to 78 % in experimental rats. Both the adhesion score (p = 0.009) and the extent of adhesions (p = 0.001) were significantly lower in the alginate group. Tissue healing histology was similar in both groups.
  
  
  CONCLUSIONS
  Ultrapure alginate gel reduces adhesion reformation following adhesiolysis.
authors.affiliation: Department of Surgery, Radboud university medical center, Nijmegen, The Netherlands, Ankit.chaturvedi@radboudumc.nl.
authors.forename: Ankit A
authors.initials: AA
authors.lastname: Chaturvedi
authors.forename: Roger M L M
authors.initials: RM
authors.lastname: Lomme
authors.forename: Thijs
authors.initials: T
authors.lastname: Hendriks
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000464:Alginates / Q000627:therapeutic use*; D000818:Animals; D002432:Cecum / Q000601:surgery; D005782:Gels; D020723:Glucuronic Acid / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000627:therapeutic use; D007813:Laparotomy; D008297:Male; D023421:Models, Animal; D010537:Peritoneum / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D017208:Rats, Wistar; D012008:Recurrence; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000464:Alginates; D005782:Gels; D006603:Hexuronic Acids; D020723:Glucuronic Acid