Evaluation the Effect of Anti-Adhesion Absorbable Gel on Untreated and Post-Restoration Small Intestine Adhesion Reduction in Rats

Document Type : Original Article

Authors

1 General Surgeon, Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences

2 Assistant Professor, Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences, Trauma Research Center

3 Expert, Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences

4 Associate Professor, Department of General Surgery, Faculty of Health and Medical Sciences, Örebro University, Sweden

5 Associate Professor of General Surgery, Shiraz University of Medical Sciences and Health Services, Shahid Rajaie Hospital, Trauma Research Center, Shiraz, Iran

Abstract
Introduction & Objective: In most cases, peritoneal adhesions are caused by abdominal surgery and is one of the most important surgical complications and causes of mortality and morbidity. These adhesions frequently cause major complications such as chronic abdominal and pelvic pain, obstruction and ileus of the small bowel, abdominal abscess, infertility in women, and prolongation of surgeries subsequent organ damage. Various methods and materials have been introduced to reduce or prevent these adhesions. One of these materials is Oxiplex-AP absorbable anti-adhesion gel, which has not been used for intra-peritoneal surgery in humans. The aim of this study was to evaluate the effect of Oxiplex / AP gel on reducing postoperative adhesions in rats. Materials & Methods: This experimental study was performed on 40 rats. The rats were randomly divided into 4 groups of 10 each. In the first group, during laparotomy, we used simple repair with Lambert sutures at the site of small bowel desertion. In the second group, in addition to Lambert suture repair, we used absorbable anti-adhesion gel at the site of injury. In the third group, small bowel desertion was left without repair and no gel in the abdomen. In the fourth group, the intestines left in the abdomen after applying the gel at the site of injury. Results: In this study, 40 rats divided in four groups. Peritoneal adhesions in all four groups were evaluated two weeks after primary surgery based on Nair criteria. The results of all four groups showed that the third adhesion type (severe) had the highest (10 cases) in the first group and the lowest (5 cases) in the fourth group. This study showed that there is significant statistics difference between treatment groups (P value = 0.05). This difference was significant between the first and fourth groups and also between the first and third groups. Conclusions: In this study, the effect of Oxiplex / AP absorbable gel was investigated which was statistically significant. The obtained data showed decreasing in the amount of adhesion in the fourth group (using absorbable anti-adhesion gel without suture) compared to the other groups and in the third group (without suture and non-gel application) comparing with the first group (suture repair) showed a decrease in adhesion. It can be claimed that this gel can decrease adhesions due to deserosation and also it can be agreed that in the absence of this gel, deserosation of less than one-third of the diameter of the intestine should be left untreated in the abdomen, which results in less adhesion than Lambert sutures without increasing the chance of intestinal perforation.

Keywords


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