Cross-linked hyaluronate hydrogel prevents adhesion formation and reformation in mouse uterine horn model

The aim of this study was to evaluate the efficacy of cross-linked hyaluron ate hydrogel (HA gel) as an adjuvant for postoperative adhesion prevention, in a mouse uterine horn model. In experiment 1 uterine horns were abrased with iodine. HA gel was applied to the injured surface before closure in th e treatment group. In experiment 2, after injuring the uterine horns, three stitches were placed at equal distances around the uterine horns to appose the injured medial surfaces of the two horns during healing. HA gel was in serted between the uterine horns in the treatment group. In experiment 3 pr evention of adhesion reformation was assessed. After lysis of adhesions tha t were induced as in experiment 2, HA gel was introduced between the serosa l surfaces of apposing uterine horns. Untreated animals served as controls in each experiment. Statistical analysis was carried out using Student's t- test. The adhesion score was significantly lower in the HA gel group on the 14th day compared with controls in all the experiments: in experiment 1, 0 .3 +/- 0.4 versus 1.7 +/- 1.2; in experiment 2, 0.9 +/- 1.0 versus 2.6 +/- 0.5; and in experiment 3, 1.5 +/- 0.9 versus 2.2 +/- 0.6 respectively. Cros s-linked HA gel significantly reduced de-novo adhesions (P < 0.03) and adhe sion reformation (P < 0.03).