An in vivo evaluation of a chondroitin sulfate solution to prevent postoperative intraperitoneal adhesion formation

Purpose. The goal of this study was to determine the efficacy of a single i ntraperitoneal administration of a chondroitin sulfate solution in preventi ng postoperative adhesion formation. Methods. Twenty-five Sprague-Dawley rats had a 1-cm(2) area of cecal serosa abraded. Controls (CON, n = 5) received no treatment, the chondroitin sulf ate group (CS, n = 10) received chondroitin sulfate (0.013 g/kg) in 0.9% Na Cl intraperitoneally (ip), and vehicle controls (VC, n = 10) received an eq ual volume of 0.9% NaCl solution ip before the abdomen was closed. All anim als were sacrificed on postoperative day 10. The extent of adhesion was qua ntified according to Mazuji's adhesion grade (0 to 4:0 = no adhesion and 4 = very dense adhesion) and quantitated after H&E, trichome, and immunohisto chemical staining for fibrin and collagen type I and type III using digital image analysis. Results. The mean Mazuji's adhesion grade in the CON was 4.0 +/- 0.0, in th e VC 2.60 +/- 0.37, and in the CS 1.3 +/- 0.42 (P < 0.01 for CS vs CON and P < 0.05 for CS vs VC comparisons). The mean gray-scale intensity (0-255: 0 = dense amount and 255 = none) of adhesion density in the CON was 105.5 +/ - 5.5, in the VC 125 +/- 15.0, and in the CS 178.3 +/- 21.0 (P < 0.01 for C S vs CON and P < 0.05 for CS vs VC comparisons). The mean adjusted intensit y stain indices (AISI) for fibrin and collagen type I in the CON were 59 +/ - 17 and 53 +/- 19, in the VC 27 +/- 3 and 25 +/- 7, and in the CS 16 +/- 5 and 6 +/- 3, respectively (P < 0.05 between CS and CON comparisons). The A ISI of collagen type III was not significant among all the groups (P > 0.1) . Conclusions. The extent of early postoperative intraabdominal adhesion form ation as determined by gross assessment and from quantitation of fibrin and collagen type I deposition was significantly reduced by a single intraperi toneal administration of a chondroitin sulfate solution. (C) 2000 Academic Press.