Abstract
Background
Surgically induced adhesions complicate up to 100% of abdominal surgeries. Food and
Drug Administration–approved treatments are generally not only less effective than
desired but they also have major contraindications. Oxychlorine species, including
chlorine dioxide (ClO2), suppress scar formation in infected wounds without affecting keratinocytes while
reducing fibroblast proliferation. The aim of the present study was to evaluate the
effect of oxychlorine solutions containing ClO2 on adhesion formation.
Methods
Male Wistar rats were subjected to Buckenmaier model of surgical adhesions and treated
with either oxychlorine solutions containing ClO2 (40–150 ppm) or isotonic saline solution. To increase the severity of adhesions,
peritonitis was produced by intraperitoneal administration of a diluted nonlethal
dose of feces (50 mg/kg). Wound strength of the healed wound was measured to evaluate
the effects of oxychlorine solutions. In addition, an oxychlorine solution of lesser
efficacy (at 100 ppm) was compared with three available anti-adhesion materials.
Results
Reproducibility of the model was validated in 26 rats. Oxychlorine solutions containing
ClO2 (40–110 ppm) significantly reduced postsurgical adhesion formation without affecting
the strength of the healed wound. Higher concentrations (120 and 150 ppm) had no effect.
Fecal peritonitis significantly increased, and solutions with ClO2 at 110 ppm significantly reduced adhesion formation. The effect of the oxychlorine
solution was significantly greater than that of Interceed, Guardix, Seprafilm, and
isotonic saline solution.
Conclusions
ClO2-containing oxychlorine solutions could be an innovative strategy for the suppression
of surgical adhesion formation, with the additional advantage of contributing antiseptic
properties.
Keywords
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References
- Abdominal adhesions: current and novel therapies.J Surg Res. 2011; 165: 91
- Adhesion prevention and reduction: current status and future recommendations of a multinational interdisciplinary consensus conference.Surg Innov. 2010; 17: 183
- Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007.Am J Surg. 2012; 204: 315
- Long-term prognosis after operation for adhesive small bowel obstruction.Ann Surg. 2004; 240: 193
- Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994.J Am Coll Surgeons. 1998; 186: 1
- Kinetics and mechanisms of chlorine dioxide and chlorite oxidations of cysteine and glutathione.Inorg Chem. 2006; 45: 8768
- Rationale for and results from a randomised, double-blind trial of tetrachlorodecaoxygen anion complex in wound healing.Lancet. 1986; 1: 825
- Prevention of postoperative adhesions by single intraperitoneal medication.J Surg Res. 1995; 59: 764
- Controlled wound repair in guinea pigs, using antimicrobials that alter fibroplasia.Am J Vet Res. 1986; 47: 96
- Comparison of antiadhesive treatments using an objective rat model.Am Surg. 1999; 65: 274
- In search of the best peritoneal adhesion model: comparison of different techniques in a rat model.J Surg Res. 2011; 167: 245
- Enteric bacteria and their antigens may stimulate postoperative peritoneal adhesion formation.Surgery. 2007; 141: 403
- Comparative study of the healing process of the aponeurosis of the anterior abdominal wall of rats after wound closure using 3-0 nylon suture and N-butil-2-cyanoacrylate tissue adhesive.Acta Cirurg Bras. 2008; 23: 352
- The effects of barrier materials on reduction of pericardial adhesion formation in rabbits: a comparative study of a hyaluronan-based solution and a temperature sensitive poloxamer solution/gel material.J Surg Res. 2011; 166: 206
- Adhesion prevention in patients with multiple cesarean deliveries.Am J Obstet Gynecol. 2011; 205: S19
Kross RD, Villanueva, C. Method for suppressing or preventing fibrous adhesion formation using a multicomponent aqueous oxychlorine composition prepared on-site. U.S. Patent application accepted for issue: April, 2013.
- Early demonstration of postoperative adhesions in a rodent model.Fertil Steril. 2010; 93: 2734
- Modulation of the expression of tissue plasminogen activator and its inhibitor by hypoxia in human peritoneal and adhesion fibroblasts.Fertil Steril. 2003; 79: 164
- Expression pattern and regulation of genes differ between fibroblasts of adhesion and normal human peritoneum.Reprod Biol Endocrinol. 2005; 3: 1
- Hypoxia regulates iNOS expression in human normal peritoneal and adhesion fibroblasts through nuclear factor kappa B activation mechanism.Fertil Steril. 2009; 91: 616
- Role of oxidative stress and NFkB in hypoxia-induced pulmonary edema.Exp Biol Med. 2008; 233: 1088
- The magnetic properties of odd molecules.J Am Chem Soc. 1926; 48: 854
- Paramagnetic resonance spectra of the alkali superoxides and chlorine dioxide.Proc Phys Soc. 1956; 69: 556
Kross RD Wound disinfection and repair. United States Patent 5,622,725; April, 1997.
Article info
Publication history
Published online: August 16, 2013
Accepted:
July 23,
2013
Received in revised form:
June 24,
2013
Received:
May 5,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
