Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model.
Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model.
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DOI：
10.7150/ijms.15167
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发表时间：
2016
影响因子：
3.6
通讯作者：
Winny M
中科院分区：
文献类型：
--
作者：
Poehnert D;Grethe L;Maegel L;Jonigk D;Lippmann T;Kaltenborn A;Schrem H;Klempnauer J;Winny M
背景：腹部手术后会出现粘连，粘连是腹痛的常见原因，也是肠梗阻和继发性女性不孕的最常见原因。这项大鼠研究研究了Adept®，Interceed®，sepilfilm®的粘连预防能力，以及一种新型设备4DryField®PH，该设备以粉末形式提供，并以凝胶形式产生效果。方法：雄性Lewis大鼠68只，均有盲肠磨损并形成等大小腹壁缺损，随机分组：对照组（n=10）；两组使用预混合凝胶（n=15）或原位凝胶技术（n=16）处理4DryField®PH；每组分别用sepilfilm®（n=8）、Interceed®（n=9）或Adept®（n=10）治疗。牺牲在第7天评估粘连的发生率、质量和数量，通过粘连减少率（AR）表示。对组织学标本进行评估。统计分析采用方差分析和非配对t检验。结果：4DryField®PH作为预混凝胶（AR: 85.2%）和原位凝胶（AR: 100%）均可显著降低粘连发生率和严重程度，两种应用技术的效果比较无差异。Seprafilm®没有显著降低粘连发生率，但严重程度显著降低（AR: 53.5%）。Interceed®（AR: 3.7%）和Adept®（AR: 16.1%）未达到明显的粘连减少。除了Interceed®的炎症反应外，组织病理学显示所有其他设备的组织相容性良好。结论：4DryField®PH和sepilfilm®具有显著的防粘连能力。4DryField®PH达到了最高的粘连预防效果，不受应用模式和相容性的限制，因此，是一种有前途的预防腹部粘连的策略。
Background: Abdominal operations are followed by adhesions, a prevalent cause of abdominal pain, and the most frequent cause for bowel obstruction and secondary female infertility. This rat study addresses adhesion prevention capability of Adept®, Interceed®, Seprafilm®, and a novel device, 4DryField® PH which is provided as powder and generates its effect as gel. Methods: Sixty-eight male Lewis rats had cecal abrasion and creation of an equally sized abdominal wall defect, and were grouped randomly: A control group without treatment (n=10); two groups treated with 4DryField® PH using premixed gel (n=15) or in-situ gel technique (n=16); one group each was treated with Seprafilm® (n=8), Interceed® (n=9), or Adept® (n=10). Sacrifice was on day 7 to evaluate incidence, quality, and quantity of adhesions, as expressed via adhesion reduction rate (AR). Histologic specimens were evaluated. Statistical analyses used ANOVA and unpaired t-tests. Results: 4DryField® PH significantly reduced incidence and severity of adhesions both as premixed gel (AR: 85.2%) and as in-situ made gel (AR: 100%), a comparison between these two application techniques showed no differences in efficacy. Seprafilm® did not reduce incidence but severity of adhesions significantly (AR: 53.5%). With Interceed® (AR: 3.7%) and Adept® (AR: 16.1%) no significant adhesion-reduction was achieved. Except for inflammatory response with Interceed®, histopathology showed good tissue compatibility of all other devices. Conclusion: 4DryField® PH and Seprafilm® showed significant adhesion prevention capabilities. 4DryField® PH achieved the highest adhesion prevention effectiveness without restrictions concerning mode of application and compatibility and, thus, is a promising strategy to prevent abdominal adhesions.