Evaluation of agar films in the prevention of postoperative peritoneal adhesions in an animal model.

Abstract

BACKGROUND: Peritoneal adhesions cause significant long-term postoperative morbidity. This study evaluates the efficacy of agar plates as the physical barrier in reducing adhesion formation after abdominal surgery in an animal model. METHODS: Adhesions were induced, by cecum abrasion, in 20 C57/BL6 mice during a laparotomy procedure. Agar plates were used in 10 mice as the experimental group. At a second operation, 28 days later, the adhesions were graded, in two groups. Data were analyzed by using Student t test. RESULTS: There was no significant difference in weight gain of the two groups during the study period. A comparison of the morphological appearances of the adhesions demonstrated that there was no evident difference between the two groups. There was also no significant difference in the incidence ratio of adhesions or postoperative adhesion scores between the two groups (p value >0.05). CONCLUSION: Despite the hydrogel properties of agar, it was not successful in practice in the reduction of adhesion formation after peritoneal surgery. Since agar is a biological product, it may cause a hyperreactivity induced by the innate immune system in peritoneum. Therefore, agar does not appear to be useful in clinical practice for the reduction of adhesion formation after peritoneal surgery.