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Song, Kim, Park, Kim, Choi, Kim, Cha, Park, Chang, Park, Park, and Hong: Effects of Three Different Types of Anti-adhesive Agents in a Rat Abdominal Wall Defect Model
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(1): 7-14.

Published online: 3 July 2009

DOI: https://doi.org/10.4174/jkss.2009.77.1.7

Effects of Three Different Types of Anti-adhesive Agents in a Rat Abdominal Wall Defect Model

Hyung Jun Song, M.D., Jong Won Kim, M.D., Jun Seok Park, M.D., Yong Seok Kim, M.D., Yoo Shin Choi, M.D., Beom Gyu Kim, M.D., Sung Jae Cha, M.D., Sung Jun Park, M.D., In Taik Chang, M.D., Sung Il Park, M.D., Eon Sub Park, M.D.1, Soon Auck Hong, M.D.1

Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.

1Department of Pathology, College of Medicine, Chung-Ang University, Seoul, Korea.

Corresponding author (Kimbg0526@paran.com)

Received 21 February 2009       Accepted 23 April 2009

Copyright © 2009 The Korean Surgical Society

Abstract

Purpose

Postsurgical adhesion formation is a significant clinical problem within every surgical specialty. Several adhesion barriers have been developed in the form of solution, membrane or film in an attempt to solve these problems. The purpose of the present study is to compare the efficacy of antiadhesive agents in the prevention of postsurgical adhesion formation in a standardized rat adhesion model.

Methods

We examined forty Sprague-Dawley rats, which is a cecal abrasion with partial peritonectomy model. Three treatment groups (Group I: Film-type Surgiwrap®, Group II: Solution-type Guardix-sol®, Group III: Membrane-type Interceed®), each consists of 10 rats, and a control group of 10 rats were used by saline. Ten days after surgery, the rats were killed, and the levels of adhesion were graded. Immunohistochemical staining for microvessel density (CD34, MVD) and macrophage (ED1) were performed in adhesion tissue.

Results

The peritoneum adhesion mean scores are as follows: control group: 2.2±0.78, Group I: 1.0±1.06, Group II: 0.9±0.99, Group III: 0.6±0.84. All treatment groups showed significantly less peritoneum adhesion (P=0.006), while there was no significant difference in each group. The intraperitoneal organs adhesion mean scores are as follows: control group: 2.8±0.91, Group I: 2.6±1.06, Group II: 1.4±0.84, Group III: 1.0±0.81. Group I had no significant difference about intraperitoneal organs adhesion with control group, but Group II and Group III showed less intraperitoneal organs adhesion. The mean numbers of microvessel density are as follows: control group: 42.5±4.83, Group I: 40.8±6.53, Group II: 30.9±6.15, Group III: 15.60±4.37, from which there was a significant difference between Group II and Group III with control group (P<0.001). The mean numbers of macrophage are as follows: control group: 223.3±33.12, Group I: 211.25±10.96, Group II: 171.60±23.96, Group III: 147.0±12.22, from which there was a significant difference between Group II and Group III with control group (P<0.001).

Conclusion

In our animal model, three different types of antiadhesive agents (Surgiwrap®, Guardix-sol®, Interceed®) were effective in adhesion prevention, but Surgiwrap® had less antiadhesive effect for intraperitoneal organs adhesion. Membrane-type Interceed® had a better effect for microvessel density (MVD) and macrophage than solution-type Guardix-sol®.

Keywords: Adhesion, Antiadhesive agents, Animal model, Microvessel density (MVD), Macrophage

Figures and Tables

Fig. 1
Classification of peritoneum adhesion severity (A) grade 1 adhesion (B) grade 3 adhesion.
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Fig. 2
Classification of intraperitoneal organs adhesion severity (A) grade 3 adhesion (B) grade 4 adhesion.
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Fig. 3
Immuohistochemical staining for CD34 (Microvessel density) in adhesion tissue (anti-CD34 stain, 1:100, ×200).
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Fig. 4
Immunohistochemical staining for ED1 (Macrophage) in adhesion tissue (anti-ED1 stain, 1:100, ×200).
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Table 1
Peritoneum adhesion scoring system
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Table 2
Intraperitoneal organ adhesion scoring system
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Table 3
Petitoneum adhesion, intraperitoneal organs adhesion, microvessel density and macrophage scores (mean±Standard Deviation) of control group and each treatment group
jkss-77-7-i003

Statistical significance test was done by Kruskall-Wallis test.

Table 4
Comparison of control group and each treatment group
jkss-77-7-i004
Table 5
Correlation between microvessel density (MVD) and macrophage with peritoneum adhesion and intraperitoneal organs adhesion
jkss-77-7-i005

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