title: Chitosan Dextran gel as an anti adhesion agent in a postlaminectomy spinal sheep model.
abstract: BACKGROUND
  Post-operative peridural adhesions increase morbidity after neurosurgical procedures. Aim of this study is to assess safety and efficacy of Chitosan-Dextran (CD) gel as an anti-adhesion agent in a spinal laminectomy sheep model.
  
  
  METHODS
  Eighteen sheep were used in this study with 6 animals in each treatment arm (namely, CD gel, Gelfoam paste and normal saline control). Posterior lumbar laminectomy was performed in all animals and the dura was exposed intact. Test agents were applied over the exposed dura and the wound was closed in layers. Sheep were euthanized at the end of three months. MRI spine was performed after euthanasia to assess epidural fibrosis. Adhesion in the spinal specimen was assessed by Peel test and histopathology was used to assess safety of the agents.
  
  
  RESULTS
  Average scores for the Peel test for CD gel, Gelfoam and normal saline control groups were 1.16 (95% CI, 0.5-1.7), 1.5 (95% CI, 0.6-2.3) and 3 (95% CI, 2.1-3.8) respectively. There was significant reduction in adhesions between treatment and normal saline treated groups (p=0.0292), with no difference between Gelfoam and CD gel groups (p=0.56). Average scores on MRI for CD gel, Gelfoam and normal saline groups were 1.4 (95% CI, 0.9-1.8), 1.5 (95% CI, 1.2-1.8) and 1.6 (95% CI, 1.3-1.8) respectively, with no significant difference in fibrosis amongst (p=0.2992). Histopathology did not show any adverse effects.
  
  
  CONCLUSIONS
  CD gel is an effective agent to reduce epidural adhesions with a good safety profile in neural tissue.
authors.affiliation: Department of Surgery - Otorhinolaryngology, Head & Neck Surgery, University of Adelaide, Adelaide, Australia. Electronic address: rajivsukanya@gmail.com.
authors.forename: Sukanya
authors.initials: S
authors.lastname: Rajiv
authors.affiliation: Department of Surgery - Otorhinolaryngology, Head & Neck Surgery, University of Adelaide, Adelaide, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Drilling
authors.affiliation: Department of Surgery - Otorhinolaryngology, Head & Neck Surgery, University of Adelaide, Adelaide, Australia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bassiouni
authors.affiliation: Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Marguerite
authors.initials: M
authors.lastname: Harding
authors.affiliation: Adelaide Pathology Partners, Adelaide, South Australia, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: James
authors.affiliation: Wakefield Nasal and Sinus Institute, Wakefield Hospital, Wellington, New Zealand.
authors.forename: Simon
authors.initials: S
authors.lastname: Robinson
authors.affiliation: Department of Chemistry, Otago University, Dunedin, New Zealand.
authors.forename: Steve
authors.initials: S
authors.lastname: Moratti
authors.affiliation: Department of Surgery - Otorhinolaryngology, Head & Neck Surgery, University of Adelaide, Adelaide, Australia.
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000818:Animals; D048271:Chitosan / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003911:Dextrans / Q000737:chemistry; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D006489:Hemostatic Techniques; D007796:Laminectomy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control* / Q000628:therapy; D012756:Sheep; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery*; D000267:Tissue Adhesions
chemical_list: D003911:Dextrans; D048271:Chitosan
keywords: Adhesions; Chitosan; Gelfoam; Laminectomy; Sheep; Spine