NOVEL ANTIADHESION BARRIER DOES NOT PREVENT ANASTOMOTIC HEALING IN A RABBIT MODEL

Citation
M. Medina et al., NOVEL ANTIADHESION BARRIER DOES NOT PREVENT ANASTOMOTIC HEALING IN A RABBIT MODEL, Journal of investigative surgery, 8(3), 1995, pp. 179-186
Citations number
25
Categorie Soggetti
Surgery
ISSN journal
08941939
Volume
8
Issue
3
Year of publication
1995
Pages
179 - 186
Database
ISI
SICI code
0894-1939(1995)8:3<179:NABDNP>2.0.ZU;2-G
Abstract
Intraperitoneal adhesions following surgical procedures cause consider able morbidity. Hyaluronic acid-carboxymethylcellulose (HA/CMC)films h ave been shown to be effective agents ill decreasing adhesion formatio n. However, when there is art inadvertent leak of bowel contents into the peritoneum due to incomplete anastomosis, adhesion. formation abou t a defect in order to prevent further leakage and to promote healing of the wound is important for the prevention of morbidity and mortalit y. The purpose of this study was to determine if an antiadhesion film (HA/CMC) impairs these potentially beneficial adhesions to bowel anast omoses, thus predisposing them to enteric leaks with subsequent perito nitis. Sixty-four rabbits were divided in two groups, each undergoing a complete or partial (90% anastomosis to simulate anastomotic leak) l arge bowel anastomosis. Half of each of the above groups were treated by wrapping a HA/CMC film over the anastomosis and the other half were untreated controls. These two subgroups were then further divided equ ally and sacrificed at either 7 or 14 days for evaluation of anastomos is integrity and strength. The average anastomotic bursting pressures did not change significantly between those groups treated with HA/CMC when compared to untreated controls at 7 or 14 days or in the complete or partial anastomosis group (Student's t rest). Adhesion formation t o the anastomosis was not impaired in either group independent of HA/C MC film application. ir;tris study suggests that while HA/CMC film has been shown to decrease adhesions in other models, healing of a rabbit colonic anastomosis even in the presence of an anastomotic defect tak es place, further suggesting that the stimulus for adhesion formation can overcome the antiadhesion properties of HA/CMC. Therefore, HA/CMC is a potentially safe adjuvant for preventing postoperative intraabdom inal adhesions.