Rajan Sundaresan Vediappan1, Catherine Bennett1, Clare Cooksley1, John Finnie2, Markus Trochsler3, Ryan D Quarrington4, Claire F Jones4,5, Ahmed Bassiouni1, Stephen Moratti6, Alkis J Psaltis1, Guy Maddern3, Sarah Vreugde1, P J Wormald1. 1. Department of Surgery-Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, Australia. 2. SA Pathology and Adelaide Medical School, The University of Adelaide, Adelaide, Australia. 3. Department of Surgery, The University of Adelaide, Adelaide, Australia. 4. Adelaide Spinal Research Group, Centre for Orthopaedic and Trauma Research, Adelaide Medical School, University of Adelaide, Adelaide, Australia. 5. School of Mechanical Engineering, University of Adelaide, Adelaide, Australia. 6. Department of Chemistry, Otago University, Dunedin, New Zealand.
Abstract
INTRODUCTION: Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in preventing adhesion formation after abdominal surgery. MATERIALS AND METHODS: 112 adult (8-10 week old) male Wistar albino rats were subjected to midline laparotomy and caecal abrasion, with 48 rats having an additional enterotomy and suturing. Kaolin (0.005g/ml) was applied to further accelerate adhesion formation. The abrasion model rats were randomized to receive saline, Chitogel, or Chitogel plus Deferiprone (5, 10 or 20 mM), together with Gallium Protoporphyrin (250μg/mL). The abrasion with enterotomy rats were randomised to receive saline, Chitogel or Chitogel with Deferiprone (1 or 5 mM). At day 21, rats were euthanised, and adhesions graded macroscopically and microscopically; the tensile strength of the repaired caecum was determined by an investigator blinded to the treatment groups. RESULTS: Chitogel with Deferiprone 5 mM significantly reduced adhesion formation (p<0.01) when pathologically assessed in a rat abrasion model. Chitogel with Deferiprone 5 mM and 1 mM also significantly reduced adhesions (p<0.05) after abrasion with enterotomy. Def-Chitogel 1mM treatment did not weaken the enterotomy site with treated sites having significantly better tensile strength compared to control saline treated enterotomy rats. CONCLUSIONS: Chitogel with Deferiprone 1 mM constitutes an effective preventative anti-adhesion barrier after abdominal surgery in a rat model. Moreover, this therapeutic combination of agents is safe and does not weaken the healing of the sutured enterotomy site.
INTRODUCTION: Adhesions are often considered to be an inevitable consequence of abdominal and pelvic surgery, jeopardizing the medium and long-term success of these procedures. Numerous strategies have been tested to reduce adhesion formation, however, to date, no surgical or medical therapeutic approaches have been successful in its prevention. This study demonstrates the safety and efficacy of Chitogel with Deferiprone and/or antibacterial Gallium Protoporphyrin in different concentrations in preventing adhesion formation after abdominal surgery. MATERIALS AND METHODS: 112 adult (8-10 week old) male Wistar albino rats were subjected to midline laparotomy and caecal abrasion, with 48 rats having an additional enterotomy and suturing. Kaolin (0.005g/ml) was applied to further accelerate adhesion formation. The abrasion model rats were randomized to receive saline, Chitogel, or Chitogel plus Deferiprone (5, 10 or 20 mM), together with Gallium Protoporphyrin (250μg/mL). The abrasion with enterotomy rats were randomised to receive saline, Chitogel or Chitogel with Deferiprone (1 or 5 mM). At day 21, rats were euthanised, and adhesions graded macroscopically and microscopically; the tensile strength of the repaired caecum was determined by an investigator blinded to the treatment groups. RESULTS: Chitogel with Deferiprone 5 mM significantly reduced adhesion formation (p<0.01) when pathologically assessed in a rat abrasion model. Chitogel with Deferiprone 5 mM and 1 mM also significantly reduced adhesions (p<0.05) after abrasion with enterotomy. Def-Chitogel 1mM treatment did not weaken the enterotomy site with treated sites having significantly better tensile strength compared to control saline treated enterotomy rats. CONCLUSIONS: Chitogel with Deferiprone 1 mM constitutes an effective preventative anti-adhesion barrier after abdominal surgery in a rat model. Moreover, this therapeutic combination of agents is safe and does not weaken the healing of the sutured enterotomy site.
Authors: Martin J Carney; Jason M Weissler; Justin P Fox; Michael G Tecce; Jesse Y Hsu; John P Fischer Journal: Am J Surg Date: 2017-01-12 Impact factor: 2.565
Authors: Jaydee D Cabral; Michelle A McConnell; Clare Fitzpatrick; Sonya Mros; Gail Williams; Peter J Wormald; Stephen C Moratti; Lyall R Hanton Journal: J Biomed Mater Res A Date: 2014-12-31 Impact factor: 4.396
Authors: Theo Athanasiadis; Achim G Beule; Brian H Robinson; Simon R Robinson; Z Shi; Peter-John Wormald Journal: Laryngoscope Date: 2008-06 Impact factor: 3.325