Reduction of adhesion formation with cross-linked hyaluronic acid after peritoneal surgery in rats

Objective: To examine the effectiveness of a cross-linked hyaluronan solution (auto-cross-linked polysaccharide [ACP] gel) for the prevention of postsurgical adhesions. Design: A randomized blinded study using a rat model of laparotomy. Setting: Surgical Research Laboratory in a university medical school. Animal(s): Sixty-seven sexually mature rats. Intervention(s): Standardized surgical trauma was induced in the rat uterine horn to induce adhesion formation. After trauma, group-1 animals (n = 23) received no treatment, group 2 (n = 21) received noncross-linked hyaluronic acid (HA), and group 3 (n = 23) received cross-linked HA applied on the lesion. Main Outcome Measure(s): Six weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Blauer's scoring system. Result(s): Overall, 84% of the untreated animals and 65% of the animals treated with noncross-linked KA presented with severe adhesions. The mean (+/-SEM) increase in the adhesion score was 2.46 +/- 0.23 in the untreated group, 2.23 +/- 0.29 in the group receiving noncross-linked HA, and 1.27 +/- 0.12 in the ACP gel group. Conclusion(s): ACP gel holds promise as a novel resorbable biomaterial for the reduction of postoperative adhesions after laparotomy. (Fertil Steril(R) 1999;72:873-8. (C)1999 by American Society for Reproductive Medicine.).