1. Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model
- Author
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Ryan D. Quarrington, Clare Cooksley, Sarah Vreugde, Ahmed Bassiouni, Claire F. Jones, Stephen C. Moratti, Peter-John Wormald, Catherine Bennett, John W. Finnie, Rajan Sundaresan Vediappan, Alkis J. Psaltis, Guy J. Maddern, and Markus Trochsler
- Subjects
Physiology ,medicine.medical_treatment ,Abrasion (medical) ,Protoporphyrins ,Adhesion (medicine) ,Tissue Adhesions ,Biochemistry ,chemistry.chemical_compound ,Cecum ,0302 clinical medicine ,Abdomen ,Medicine and Health Sciences ,Deferiprone ,Kaolin ,030223 otorhinolaryngology ,Immune Response ,Saline ,Multidisciplinary ,Enterostomy ,medicine.anatomical_structure ,Abdominal Surgery ,030220 oncology & carcinogenesis ,Medicine ,Anatomy ,Research Article ,medicine.medical_specialty ,Colon ,Science ,Immunology ,Surgical and Invasive Medical Procedures ,Research and Analysis Methods ,Enterotomy ,03 medical and health sciences ,Signs and Symptoms ,Tensile Strength ,Tissue Repair ,medicine ,Animals ,Rats, Wistar ,Inflammation ,Chitosan ,Wound Healing ,business.industry ,Biology and Life Sciences ,Proteins ,medicine.disease ,Rats ,Surgery ,Gastrointestinal Tract ,Disease Models, Animal ,chemistry ,Specimen Preparation and Treatment ,Clinical Medicine ,Physiological Processes ,business ,Gels ,Digestive System ,Collagens ,Abdominal surgery - 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 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.
- Published
- 2021