title: Efficacy and Safety of Ultrapure Alginate-Based Anti-Adhesion Gel in Experimental Peritonitis.
abstract: BACKGROUND
  Intra-abdominal infection may lead to adhesion and abscess formation. An adhesion barrier can reduce these complications but also aggravate intra-peritoneal infection, causing the opposite effects. The fear of infection propagation has limited clinical adhesion barrier use in a contaminated or infected abdomen. This study evaluated both adhesion and abscess reduction and infection propagation of a new ultrapure alginate-based anti-adhesive barrier gel in a rat peritonitis model.
  
  
  METHODS
  In 64 male Wistar rats, bacterial peritonitis was induced via intra-abdominal injection of a mixture of sterile feces, 10(5) colony-forming units (CFU) of Escherichia coli, and 10(4) CFU of Bacteroides fragilis. Surgical debridement and peritoneal lavage were performed 1 h after inoculation. Animals were randomly allocated in equal numbers to a control group or an alginate gel group. Animals were sacrificed on day five post-operatively. Death and the presence and size of intra-abdominal abscesses were noted, and adhesions were scored. All outcomes were compared in the two groups.
  
  
  RESULTS
  Seventeen rats (27%) died prematurely without any difference between the groups. Of the surviving rats in the alginate gel group, 88% developed abscesses vs. 100% of the control group. There was no significant difference in the abscess scores or incidence rates of adhesion formation between the groups. The adhesion scores were lower for the alginate gel group compared with control animals (p=0.04).
  
  
  CONCLUSIONS
  Ultrapure alginate gel reduces adhesion severity but not abscesses. The gel seemed to be safe, not aggravating intra-peritoneal infection in this abdominal infection model.
authors.affiliation: 1 Department of Surgery, Radboud University Medical Centre , Nijmegen, The Netherlands .|2 European Medical Contract Manufacturing B.V , Nijmegen, The Netherlands .
authors.forename: Ankit A
authors.initials: AA
authors.lastname: Chaturvedi
authors.affiliation: 1 Department of Surgery, Radboud University Medical Centre , Nijmegen, The Netherlands .
authors.forename: Otmar R
authors.initials: OR
authors.lastname: Buyne
authors.affiliation: 1 Department of Surgery, Radboud University Medical Centre , Nijmegen, The Netherlands .
authors.forename: Roger M L M
authors.initials: RM
authors.lastname: Lomme
authors.affiliation: 1 Department of Surgery, Radboud University Medical Centre , Nijmegen, The Netherlands .
authors.forename: Thijs
authors.initials: T
authors.lastname: Hendriks
authors.affiliation: 1 Department of Surgery, Radboud University Medical Centre , Nijmegen, The Netherlands .
authors.forename: Harry
authors.initials: H
authors.lastname: Van Goor
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology; D000464:Alginates / Q000627:therapeutic use*; D000818:Animals; D001835:Body Weight; D004195:Disease Models, Animal; D005782:Gels; D020723:Glucuronic Acid / Q000627:therapeutic use; D006603:Hexuronic Acids / Q000627:therapeutic use; D008297:Male; D010538:Peritonitis / Q000150:complications* / Q000401:mortality; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
chemical_list: D000464:Alginates; D005782:Gels; D006603:Hexuronic Acids; D020723:Glucuronic Acid