OBJECTIVE: To examine the effect of hyaluronic acid, a high-molecular-weight glucosaminoglycan found in the extracellular matrix, on the formation of adhesions, a major source of postoperative complications. DESIGN: The ability of hyaluronic acid to reduce adhesion formation was evaluated using a standardized rabbit model. The material was administered i.p. at the end of surgery. SETTING: University laboratory. ANIMAL(S): New Zealand White female rabbits. INTERVENTION(S): Intraperitoneal administration of various formulations of hyaluronic acid at the end of surgery. MAIN OUTCOME MEASURE(S): One week after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. RESULT(S): Five separate molecular weight ranges of hyaluronic acid representing eight viscosities between 1,000 and 12,000 centipoise (CPS) were shown to reduce adhesion formation in this model. All volumes, 1 to 30 mL, of hyaluronic acid tested reduced adhesion formation. In addition, the low-viscosity, low-molecular-weight hyaluronic acid significantly reduced adhesion formation when added to the trauma site or when injected at a site remote from the trauma area. CONCLUSION(S): This study showed that hyaluronic acid administered at the end of surgery reduced adhesion formation.
OBJECTIVE: To examine the effect of hyaluronic acid, a high-molecular-weight glucosaminoglycan found in the extracellular matrix, on the formation of adhesions, a major source of postoperative complications. DESIGN: The ability of hyaluronic acid to reduce adhesion formation was evaluated using a standardized rabbit model. The material was administered i.p. at the end of surgery. SETTING: University laboratory. ANIMAL(S): New Zealand White female rabbits. INTERVENTION(S): Intraperitoneal administration of various formulations of hyaluronic acid at the end of surgery. MAIN OUTCOME MEASURE(S): One week after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. RESULT(S): Five separate molecular weight ranges of hyaluronic acid representing eight viscosities between 1,000 and 12,000 centipoise (CPS) were shown to reduce adhesion formation in this model. All volumes, 1 to 30 mL, of hyaluronic acid tested reduced adhesion formation. In addition, the low-viscosity, low-molecular-weight hyaluronic acid significantly reduced adhesion formation when added to the trauma site or when injected at a site remote from the trauma area. CONCLUSION(S): This study showed that hyaluronic acid administered at the end of surgery reduced adhesion formation.
Authors: Arin K Greene; Ian P J Alwayn; Vania Nose; Evelyn Flynn; David Sampson; David Zurakowski; Judah Folkman; Mark Puder Journal: Ann Surg Date: 2005-07 Impact factor: 12.969