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Ibrahim A, Kamel WH, Soliman M. Efficacy of gelatin sponge in the prevention of post-surgical intra-abdominal adhesion in a rat model. Res Vet Sci 2022; 152:26-33. [PMID: 35914363 DOI: 10.1016/j.rvsc.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/19/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022]
Abstract
Although different products have been developed to prevent post-surgical adhesion, their efficacy remains unsatisfactory. This study aimed to evaluate the efficacy of the gelatin sponge in the prevention of post-surgical intra-abdominal adhesions in a rat model. Rats were randomly divided into sham, adhesion, and gelatin groups. All rats, except the sham group, underwent cecal abrasion to establish an adhesion model. After celiotomy, a sterile gelatin sponge was applied intra-abdominal on the abraded cecum in the gelatin group. Rats were sacrificed on day 14 post-surgery and intra-abdominal adhesions were evaluated and scored. Adhesion tissues were evaluated by histological, histochemical, and immunohistochemical analysis. Intra-abdominal adhesions were recorded in all rats of the adhesion group. Intra-abdominal application of gelatin sponge significantly (P < 0.001) reduced intra-abdominal adhesions by 91% in the gelatin group relative to the adhesion group. The histological analysis revealed a marked decrease (P < 0.001) in the inflammatory score and neovascularization in the gelatin group. The histochemical analysis found that gelatin sponge administration reduced adhesion formation and thickness of adhesion tissue. Moreover, gelatin sponge significantly (P < 0.0001) increased MMP-9 expression and decreased macrophage marker expression in adhesive tissue. This study revealed that the application of gelatin sponge markedly reduced the post-surgical intra-abdominal adhesions and suggests new guidance for using gelatin sponge as an anti-adhesive substance in clinical practice.
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Affiliation(s)
- Ahmed Ibrahim
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt.
| | - Walaa H Kamel
- Department of Veterinary Pathology and Clinical Pathology, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt..
| | - Mahmoud Soliman
- Department of Veterinary Pathology and Clinical Pathology, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt.; Laboratory of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju 81186, Republic of Korea.
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Betancourt-Vicencio S, Prieto-Aldape MR, Alvarez-Villaseñor AS, Fuentes-Orozco C, Cortes-Flores AO, Castillo-Cardiel G, Sánchez-Martínez JA, Reyes-Elizalde EA, González-Hernández PG, Zamora-Inzunza JG, Romero-Arredondo VA, Barbosa-Camacho JF, Brancaccio-Pérez IV, Guzmán-Ramírez BG, González-Ojeda A. Effects of Oral Pirfenidone on Colon Anastomosis Healing and Adhesion Formation in Rats. Eur Surg Res 2022; 63:241-248. [PMID: 35196655 DOI: 10.1159/000523711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/15/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Many experimental studies have examined multiple drugs or treatments to improve the healing of intestinal anastomoses. Synthetic prostacyclin analogs, immunosuppressants, erythropoietin, growth hormone, insulin-like growth factor type 1, synthetic metalloproteinases inhibitors, and hyperbaric oxygen therapy have produced promising results in low-risk models of anastomosis dehiscence. However, in high-risk models, only hyperbaric oxygen therapy has been shown to be useful. Pirfenidone (PFD), a commonly used antifibrosing drug, has not been shown to be effective for this purpose. Our objective was to evaluate the effects of PFD on anastomosis healing and adhesion genesis in a low-risk rat model of dehiscence of colonic anastomosis. METHODS An experimental study was conducted on 40 healthy Wistar rats randomly assigned to the control group or PFD experimental group (20 rats in each group). Colon anastomosis was performed 3 cm above the peritoneal reflection using the same technique in all animals. Mechanical resistance was studied by measuring bursting pressure. Adhesions were evaluated macroscopic and histologically using common staining techniques. Animals received the first PFD dose 12 h after surgery at a dose of 500 mg/kg one a day (SID) for 5 consecutive days. On day 6, the animals were reoperated on to measure the bursting pressure in situ and to classify adhesions macroscopically, and the anastomosed colon was resected for histological analysis. RESULTS There were no deaths, complications, or anastomosis dehiscence in either group. The mean bursting pressure was 120.8 ± 11 mm Hg and 135.5 ± 12.4 in the control and PFD groups, respectively (p < 0.001). The adhesions were less dense and had less inflammatory cell infiltration in the PFD group (p < 0.02 and 0.002, respectively). Collagen content was slightly higher in the PFD group (p = 0.04). CONCLUSIONS Our results revealed favorable effects of PFD in this low-risk colon anastomosis model; for example, the bursting pressure was higher, and the macroscopic adhesions were soft and exhibited less inflammatory infiltration and higher collagen content in the PFD group than in the control group. The results showing that PFD treatment was associated with better healing of minor adhesions seem to be paradoxical because the therapeutic indications for this drug are directed at treating fibrosing diseases.
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Affiliation(s)
- Shadya Betancourt-Vicencio
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - Manuel Rodrigo Prieto-Aldape
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Guadalupe Castillo-Cardiel
- Department of Maxillofacial Surgery, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Mexico
| | - José Antonio Sánchez-Martínez
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - Emilio Alberto Reyes-Elizalde
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - José Gerardo Zamora-Inzunza
- Department of General Surgery, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Mexico
| | | | | | - Irma Valeria Brancaccio-Pérez
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
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Fuentes-Orozco C, Agredano-Jiménez R, Alvarez-Villaseñor AS, Mares-País R, Barbosa-Camacho FJ, Cortés-Flores AO, Reyes-Elizalde EA, Guzmán-Ramírez BG, Flores-Becerril P, Guzmán-Barba JA, Chejfec-Ciociano JM, Ibarrola-Peña JC, Brancaccio-Pérez IV, González-Ojeda A. Effects of Oral Zafirlukast, Sildenafil, or Pirfenidone on the Formation of Postsurgical Intra-abdominal Adhesions in an Experimental Rat Model. Eur Surg Res 2021; 63:145-154. [PMID: 34818645 DOI: 10.1159/000521036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Intra-abdominal adhesions' main etiology is surgical procedures that commonly require reintervention. Oral treatments with Sildenafil, Zafirlukast, and Pirfenidone have yielded decreased severity of fibrotic phenomena secondary to the introduction of foreign material. This study aimed to evaluate the efficacy of oral Zafirlukast, Sildenafil or Pirfenidone treatment on reducing or preventing intra-abdominal adhesions in an experimental rat model. METHODS Four groups, each of 10 male Wistar rats weighing 250-300 g, were used. A midline laparotomy was used to excise an area of 1.5´1.5cm and reconstructed with polypropylene mesh fixed to the abdominal wall. After 12 h, oral doses of Zafirlukast (1.25 mg/kg, group B), Sildenafil (15 mg/kg, group C), or Pirfenidone (500 mg/kg, group D) were given every day for eight days. The control group, A, received no treatment. At day nine, animals were reoperated. The implant was resected after ethically approved euthanasia and specimens were fixed in 10% formaldehyde for histopathology. RESULTS Control group A yielded adhesions with greater fibrovascular density and neighboring organ involvement than the other groups (P = 0.001), as well as intense inflammatory infiltrates and numerous granulomas (P = 0.04). Adhesions in group C had less fibrovascular density (P = 0.03) with decreased serosal injuries (P = 0.001) and less organ involvement. Group D had reduced adhesions without organ involvement (P < 0.01), and less inflammatory infiltrates, collagen fibers, and foreign body granulomas than groups B or C (P < 0.01). CONCLUSIONS Oral administration of these agents did not prevent adhesions but ameliorated them. Oral Pirfenidone offered the best performance and could be recommended for human use.
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Affiliation(s)
- Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - Ruben Agredano-Jiménez
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Roberto Mares-País
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | | | - Emilio Alberto Reyes-Elizalde
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Paola Flores-Becerril
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - José Aldo Guzmán-Barba
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | | | - Juan Carlos Ibarrola-Peña
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - Irma Valeria Brancaccio-Pérez
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
| | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Western National Medical Center, Social Security Mexican Institute, Guadalajara, Mexico
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Wei G, Wu Y, Gao Q, Shen C, Chen Z, Wang K, Yu J, Li X, Sun X. Gallic Acid Attenuates Postoperative Intra-Abdominal Adhesion by Inhibiting Inflammatory Reaction in a Rat Model. Med Sci Monit 2018; 24:827-838. [PMID: 29429982 PMCID: PMC5815494 DOI: 10.12659/msm.908550] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/23/2018] [Indexed: 02/06/2023] Open
Abstract
Background Intra-abdominal adhesion is one of the most common complications after abdominal surgery. The efficacy of current treatments for intra-abdominal adhesion is unsatisfactory. In this study, we investigated the effect of gallic acid on the prevention and treatment of intra-abdominal adhesions after abdominal surgery using an intra-abdominal adhesion rat model. Material/Methods The experimental rats were randomly divided into the sham operation group, the control group, the chitosan group, and 3 gallic acid groups of different concentrations. All rats except those in the sham operation group received cecal abrasion to induce adhesion. From the first postoperative day, the rats in the gallic acid groups were administered different concentrations of gallic acid in a 2-ml gavage daily. All rats were sacrificed on postoperative day 7, and the degree of intra-abdominal adhesion was evaluated by the naked eye. The amount of collagen deposited between the injured peritoneal tissues was assessed by Sirius red staining. Serum levels of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and transforming growth factor-β (TGF-β) were measured by ELISA. Western blot was used to detect the level of NF-κB phosphorylation in the injured peritoneal or adhesion tissues of the rats. Results Compared with the control group, the scores of intra-abdominal adhesions in the rats treated with larger doses of gallic acid were significantly decreased, and the degree of inflammation and fibrosis was also significantly decreased. Gallic acid significantly reduced IL-6, TNF-α, and TGF-β1 serum levels. NF-κB phosphorylation in the higher gallic acid groups was significantly reduced. Conclusions Gallic acid inhibits the formation of postoperative intra-abdominal adhesions in rats by inhibiting the inflammatory reaction and fibrogenesis. Gallic acid is a promising drug for preventing intra-abdominal adhesions.
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Affiliation(s)
- Guangbing Wei
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Yunhua Wu
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Qi Gao
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Cong Shen
- Department of Medical Imaging, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Zilu Chen
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Kang Wang
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Junhui Yu
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Xuqi Li
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
| | - Xuejun Sun
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
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