EVALUATION OF CMC AND HA SOLUTIONS FOR ADHESIOLYSIS

Aqueous hyaluronic acid (HA) and carboxymethylcellulose (CMC) solution s were tested as tissue-protective coatings during lysis of surgical a dhesions by blunt dissection or electrocautery in a rat cecal abrasion model. Phosphate-buffered saline (PBS) was used as a tissue coating s olution in 200 female Sprague-Dawley rats prior to controlled cecal ab rasion with a surgical gauze-tipped rotary abrader (four 1.5-cm-diamet er areas; 70 g weight/60 revolutions/130 rpm), One week after this ini tial cecal abrasion, rats were operated on again and adhesions were sc ored and lysed. The rats were randomly assigned to receive experimenta t tissue coating solutions either before (prelysis; n = 160) or after (postlysis; n = 40) adhesiolysis. Animals with prelysis coatings were further divided into blunt dissection or electrocautery adhesiolysis g roups and were rested with 2 mL cecal coating of PBS, 0.4% HA, 0.5% CM C, or 1.0% CMC tissue coating solutions (n = 20/group). Rats treated p ostlysis received 2 mL cecal coating plus 2 mL, intraperitoneal instil lation of PBS, 1.8, 1.9, or 2.0% CMC. One week after adhesiolysis, rat s were operated on again for final adhesion scoring. Prelysis tissue c oating with 0.5 or 1.0% CMC solution appeared to inhibit adhesion refo rmation after blunt dissection, whereas 0.4% HA was not effective in t his model. Solutions applied before electrocautery dissection or after blunt dissection were ineffective.