Preventing Intraperitoneal Adhesions With Ethyl Pyruvate and Hyaluronic Acid/Carboxymethylcellulose: A Comparative Study in an Experimental Model

Abstract

Results: Median macroscopic intraperitoneal adhesion scores for the control, EP and Seprafilm groups were 2.8, 1.2 and 1.1, respectively. Multiple comparisons between groups showed a significant difference (p < 0.05). In binary comparisons, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p < 0.05). No significant difference was found between the adhesion scores for the EP group and the Seprafilm group (p > 0.05). After histopathological evaluation, significant differences in all parameters were found between the groups (p < 0.05). In the paired comparison, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p < 0.0167), but no significant difference was found between the EP group and the Seprafilm group (p > 0.0167).Objective: To compare the effectiveness of ethyl pyruvate (EP) with that of hyaluronic acid + carbox- ymethyl cellulose (Seprafilm) for the prevention of intraperitoneal adhesions. Seprafilm has been shown to be effective in many experimental and clinical studies.Study design: Thirty rats were divided into three groups at random, and uterine horn abrasion was performed by laparotomy. One group received no treatment (control group), one group received a single intraperitoneal dose of EP 50 mg/kg (EP group), and a 2 × 1-cm patch of Seprafilm was applied in the third group (Seprafilm group). All rats were killed 14 days after surgery. Macroscopic and histopathological evaluation were performed by a surgeon and a pathologist who were blinded to group allocation. Histopathologically, inflammation, fibroblastic activity, foreign body reaction, collagen proliferation, vascular proliferation, Masson-Trichrome score, matrix metalloproteinase-2 score and vascular endothelial growth factor score were studied.Conclusions: In comparison with the untreated control group, EP and Seprafilm were found to reduce the formation of intraperitoneal adhesions. No significant difference was found between EP and Seprafilm. © 2014 Elsevier Ireland Ltd. All rights reserved.