D. Bowers et al., Hyaluronic acid-carboxymethylcellulose film and perianastomotic adhesions in previously irradiated rats, AM J OBST G, 181(6), 1999, pp. 1335-1337
OBJECTIVE: Postoperative intra-abdominal adhesions are a major source of po
stsurgical morbidity. Pelvic irradiation increases the likelihood of adhesi
on development. The purpose of this study was to evaluate the effects of hy
aluronic acid-carboxymethylcellulose film, which was designed as a barrier
to prevent adhesions, on the healing of ileal anastomoses performed on irra
diated rat bowel.
STUDY DESIGN: Sixty-eight female Sprague-Dawley rats underwent whole pelvic
irradiation with a single fraction of 1700 cGy Twenty weeks later the rats
underwent exploratory laparotomy with segmental ileal resection and reanas
tomosis. Eighteen of the anastomoses were wrapped in hyaluronic acid-carbox
ymethylcellulose film. Fifty anastomoses were not treated with any adhesion
-inhibiting barrier. On the fifth postoperative day the animals underwent a
nother laparotomy for evaluation of the anastomotic sites.
RESULTS: At the second laparotomy 93% of the rats treated with hyaluronic a
cid-carboxymethylcellulose film were found to have perianastomotic abscesse
s. In the non-hyaluronic acid-carboxymethylcellulose film group the periana
stomotic abscess rate was 24% (P < .0001).
CONCLUSION: Among previously irradiated rats undergoing small-bower resecti
on and anastomosis, hyaluronic acid-carboxymethylcellulose film was associa
ted with a markedly increased rate of abscess formation at the operative si
te.