A Novel Method for Evaluating Postoperative Adhesions in Rats.
Purpose/Aim: Postoperative adhesions remain an undesirable and commonly symptomatic side effect of abdominopelvic surgeries. Animal models of postoperative adhesions typically yield heterogeneous adhesions throughout the abdominal cavity and are not easily quantified. Here we present a novel method of postoperative adhesion assessment and report its reliability and measurement error.


METHODS
A model of cecal abrasion with partial sidewall attachment was performed on female rats. After 1, 2, 4, or 7 days of recovery, the rats were euthanized and their abdominopelvic cavities were systematically evaluated for postoperative adhesions. The necropsy was recorded through the surgical microscope. Four raters were trained to use a ballot to capture key factors of the adhesions as they viewed the recordings. Their ratings were compared for measurement error and reliability (using Bland-Altman plots and intraclass correlation coefficients, respectively) and for the ability to discriminate differences in experimental groups. A subset of the data was analyzed to determine practical utility.


RESULTS
The rating system was shown to have low measurement error and high inter-rater reliability for all parameters measured. Applied practically, the system was able to discriminate groups in a manner that was expected.


CONCLUSIONS
We have developed and validated a rating system for postoperative adhesions and shown that it can detect group differences. This method can be used to quantify postoperative adhesions in rodent models.
a Department of Biomedical Sciences , University of New England College of Osteopathic Medicine , Biddeford , ME , USA.
Geoffrey M
GM
Bove
a Department of Biomedical Sciences , University of New England College of Osteopathic Medicine , Biddeford , ME , USA.|b Squamish Integrated Health , Squamish , BC , Canada.
Susan L
SL
Chapelle
c Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.|d University of Toronto , Dalla Lana School of Public Health , Toronto , ON , Canada.
Eleanor
E
Boyle
a Department of Biomedical Sciences , University of New England College of Osteopathic Medicine , Biddeford , ME , USA.
David J
DJ
Mokler
c Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.|e Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark , Odense M , Denmark.
Jan
J
Hartvigsen
D000818:Animals; D001672:Biocompatible Materials; D002432:Cecum / Q000473:pathology; D003949:Diagnostic Techniques, Surgical; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004195:Disease Models, Animal; D005260:Female; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D051381:Rats; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000175:diagnosis / Q000473:pathology
D001672:Biocompatible Materials
bowel obstruction; gastrointestinal surgery; infertility; postoperative adhesions; rat; reliability
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