Reduction of adhesion formation with cross-linked hyaluronic acid after peritoneal surgery in rats.

OBJECTIVE

To examine the effectiveness of a cross-linked hyaluronan solution (auto-cross-linked polysaccharide [ACP] gel) for the prevention of postsurgical adhesions.

DESIGN

A randomized blinded study using a rat model of laparotomy.

SETTING

Surgical Research Laboratory in a university medical school.

ANIMAL(S): Sixty-seven sexually mature rats.

INTERVENTION(S): Standardized surgical trauma was induced in the rat uterine horn to induce adhesion formation. After trauma, group-1 animals (n = 23) received no treatment, group 2 (n = 21) received noncross-linked hyaluronic acid (HA), and group 3 (n = 23) received cross-linked HA applied on the lesion.

MAIN OUTCOME MEASURE(S): Six weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Blauer's scoring system.

RESULT(S): Overall, 84% of the untreated animals and 65% of the animals treated with noncross-linked HA presented with severe adhesions. The mean (+/-SEM) increase in the adhesion score was 2.46+/-0.23 in the untreated group, 2.23+/-0.29 in the group receiving noncross-linked HA, and 1.27+/-0.12 in the ACP gel group.

CONCLUSION(S): ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparotomy.