The Effects of Hydrophilic Polyethylene Glycol-Based Adhesion Barrier Use to Prevent Intra-abdominal Adhesions in Intra-abdominal Sepsis Model

Abstract

Postoperative adhesion formation is still an important cause of morbidity and mortality. Hydrophilic polyethylene glycol-based adhesion barrier (SprayGel (TM), Confluent Surgical, Inc., Waltham, MA) is reportedo prevent adhesion formation after gynecologic surgery. This study aims to determine the effectiveness of SprayGel (TM) on adhesion formation after laparotomy in an experimental septic peritonitis model. Wistar albino male rats with weights of 250-350 g were used in this study. Forty rats were grouped into four groups: group I (control), laparotomy and sham operation; group II, laparotomy and cecal ligation puncture (CLP); group III (SprayGel (TM)), laparotomy, sham operation, and SprayGel (TM); group IV (CLP + SprayGel (TM)), laparotomy, CLP, and SprayGel (TM). Intra-abdominal sepsis was achieved by perforating the cecum with a 26-gauge needle in selected groups. All animals were sacrificed after 10 days. The results were evaluated according to the score systems of Nair and Knightly. Kruskal-Wallis variance analysis was used for statistical analysis. There were significant differences for the development of adhesion between groups II (CLP) and III-IV (SprayGel (TM) - CLP + SprayGel (TM)) (p<0.02). Mortality and wound infection rates were significantly lower in the SprayGel (TM) treatment groups compared to control groups. Intraperitoneal administration of SprayGel (TM) significantly decreased the intraperitoneal adhesion formation, and it reduced mortality and wound infection as well.