Peck L S, Quigg J M, Fossum G T, Goldberg E P
Department of Materials Science and Engineering, University of Florida, Gainesville 32611, USA.
J Invest Surg. 1995 Sep-Oct;8(5):337-48. doi: 10.3109/08941939509015380.
Aqueous hyaluronic acid (HA) and carboxymethylcellulose (CMC) solutions were tested as tissue-protective coatings during lysis of surgical adhesions by blunt dissection or electrocautery in a rat cecal abrasion model. Phosphate-buffered saline (PBS) was used as a tissue coating solution in 200 female Sprague-Dawley rats prior to controlled cecal abrasion with a surgical gauze-tipped rotary abrader (four 1.5-cm-diameter areas; 70 g weight/60 revolutions/130 rpm). One-week after this initial cecal abrasion, rats were operated on again and adhesions were scored and lysed. The rats were randomly assigned to receive experimental 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 groups and were tested with 2 mL cecal coating of PBS, 0.4% HA, 0.5% CMC, or 1.0% CMC tissue coating solutions (n = 20/group). Rats treated postlysis received 2 mL cecal coating plus 2 mL intraperitoneal instillation of PBS, 1.8, 1.9, or 2.0% CMC. One week after adhesiolysis, rats were operated on again for final adhesion scoring. Prelysis tissue coating with 0.5 or 1.0% CMC solution appeared to inhibit adhesion reformation after blunt dissection, whereas 0.4% HA was not effective in this model. Solutions applied before electrocautery dissection or after blunt dissection were ineffective.
在大鼠盲肠擦伤模型中，通过钝性分离或电灼法进行手术粘连松解时，对透明质酸（HA）水溶液和羧甲基纤维素（CMC）溶液作为组织保护涂层进行了测试。在用带手术纱布尖端的旋转研磨器对200只雌性斯普拉格 - 道利大鼠进行可控盲肠擦伤之前（四个直径1.5厘米的区域；70克重量/60转/130转/分钟），使用磷酸盐缓冲盐水（PBS）作为组织涂层溶液。在初次盲肠擦伤一周后，再次对大鼠进行手术，对粘连进行评分并松解。大鼠被随机分配在粘连松解前（预松解；n = 160）或后（松解后；n = 40）接受实验性组织涂层溶液。预松解涂层的动物进一步分为钝性分离或电灼粘连松解组，并用2毫升盲肠涂层的PBS、0.4% HA、0.5% CMC或1.0% CMC组织涂层溶液进行测试（每组n = 20）。松解后治疗的大鼠接受2毫升盲肠涂层加2毫升腹腔内注入PBS、1.8%、1.9%或2.0% CMC。粘连松解一周后，再次对大鼠进行手术以进行最终粘连评分。用0.5%或1.0% CMC溶液进行预松解组织涂层似乎能抑制钝性分离后粘连的重新形成，而0.4% HA在该模型中无效。在电灼分离前或钝性分离后应用的溶液无效。
