title: Work of separation - A method to assess intraperitoneal adhesion and healing of parietal peritoneum in an animal model.
abstract: BACKGROUND
  Adhesion grades and adhesion breaking strength are widely used to assess severity of intraperitoneal adhesion in animal models. However, the results of adhesion grades have the large deviations due to vary personal experience. Adhesion breaking strength ignores the details of adhesion. This study introduced work of separation, the energy consumption during breakage of adhesion, to better evaluate intraperitoneal adhesion.
  
  
  METHODS
  The intraperitoneal adhesion was induced by traumas created at rat cecum and adjacent abdominal wall. The wounds were coated with or without sodium hyaluronate. On day 14 after surgery, the intraperitoneal adhesion was assessed by adhesion density grade, adhesion area grade, adhesion breaking strength and work of separation. The healing of parietal peritoneum was evaluated with histology, adhesion breaking strength and work of separation.
  
  
  RESULTS
  The severity of adhesion evaluated with work of separation was consistent with those obtained from the grades of adhesion density, adhesion area and adhesion breaking strength. Work of separation had a linear correlation with adhesion breaking strength. Furthermore, the results of histological examination and work of separation demonstrated that adhesion significantly delayed healing process of abdominal wall muscles.
  
  
  CONCLUSIONS
  Work of separation can quantify all intraperitoneal adhesions rather than the major one by other methods. It is a more precise method to evaluate postoperative adhesions, especially those including adipose tissue. This study proved that work of separation could be a reliable method to assess intraperitoneal adhesion and tissue healing.
authors.affiliation: Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Long-Xiang
authors.initials: LX
authors.lastname: Lin
authors.affiliation: Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yuan
authors.affiliation: Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Hui-Hui
authors.initials: HH
authors.lastname: Zhang
authors.affiliation: Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China. Electronic address: yl.sun@siat.ac.cn.
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Sun
mesh_terms: D034861:Abdominal Wall / Q000503:physiopathology; D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D010532:Peritoneal Diseases / Q000473:pathology / Q000503:physiopathology*; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000503:physiopathology; D014945:Wound Healing / Q000502:physiology*
chemical_list: D006820:Hyaluronic Acid
keywords: Abdominal adhesion; Adhesion breaking strength; Adhesion grade; Work of separation