Effects of hyaluronic acid/carboxymethylcellulose gel on bowel anastomoses in the New Zealand white rabbit

Intra-abdominal adhesions form in more than 90% of patients undergoing major abdominal surgery and can lead to significant complications. Application of a bioresorbable gel consisting of chemically modified hyaluronic acid (HA) and carboxymethylcellulose (CMC) has shown promise as a means of prevent...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 1997-11, Vol.1 (6), p.569-575
Main Authors: Hadaegh, A, Burns, J, Burgess, L, Rose, R, Rowe, E, LaMorte, W W, Becker, J M
Format: Article
Language:English
Subjects:
Abdomen
Adhesion
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - methods
Animals
Carboxymethylcellulose Sodium - pharmacology
Gels
Hyaluronic Acid - pharmacology
Ileum - drug effects
Ileum - surgery
Intestinal Diseases - prevention & control
Rabbits
Surgery
Tissue Adhesions - prevention & control
Wound Healing - drug effects
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Summary:Intra-abdominal adhesions form in more than 90% of patients undergoing major abdominal surgery and can lead to significant complications. Application of a bioresorbable gel consisting of chemically modified hyaluronic acid (HA) and carboxymethylcellulose (CMC) has shown promise as a means of preventing intra-abdominal adhesions, but there have been concerns that the presence of the gel might interfere with the integrity and healing of bowel anastomoses. We tested the effects of HA/CMC gel on adhesion formation and anastomotic healing in 60 New Zealand white rabbits after transection and complete (100%) or incomplete (90%) anastomosis of the ileum. Half of the animals underwent application of HA/CMC gel and half served as control subjects. Animals were killed at 4, 7, or 14 days after surgery. Anastomotic adhesions were scored in a blinded fashion. Integrity of the anastomosis was tested by measuring bursting pressure at the anastomotic site and in an adjacent section of intact bowel. With complete anastomosis, HA/CMC gel significantly reduced adhesion formation at 7 and 14 days after surgery (P
ISSN:1091-255X
1873-4626
DOI:10.1016/s1091-255x(97)80074-1