Gastrointestinal| Volume 186, ISSUE 1, P164-169, January 2014

Download started.


Oxychlorine species suppress postsurgical adhesions in rats

Published:August 16, 2013DOI:



      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.


      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.


      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.


      ClO2-containing oxychlorine solutions could be an innovative strategy for the suppression of surgical adhesion formation, with the additional advantage of contributing antiseptic properties.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Surgical Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ward B.C.
        • Panitch A.
        Abdominal adhesions: current and novel therapies.
        J Surg Res. 2011; 165: 91
        • Diamond M.P.
        • Wexner S.D.
        • diZereg G.S.
        • et al.
        Adhesion prevention and reduction: current status and future recommendations of a multinational interdisciplinary consensus conference.
        Surg Innov. 2010; 17: 183
        • Scott F.I.
        • Osterman M.T.
        • Mahmoud N.N.
        • et al.
        Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007.
        Am J Surg. 2012; 204: 315
        • Fevang B.T.
        • Fevang J.
        • Lie S.A.
        • et al.
        Long-term prognosis after operation for adhesive small bowel obstruction.
        Ann Surg. 2004; 240: 193
        • Ray N.F.
        • Denton W.G.
        • Thamer M.
        • et al.
        Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994.
        J Am Coll Surgeons. 1998; 186: 1
        • Ison A.
        • Odeh I.N.
        • Margerum D.W.
        Kinetics and mechanisms of chlorine dioxide and chlorite oxidations of cysteine and glutathione.
        Inorg Chem. 2006; 45: 8768
        • Hinz J.
        • Hautzinger H.
        • Stahl K.W.
        Rationale for and results from a randomised, double-blind trial of tetrachlorodecaoxygen anion complex in wound healing.
        Lancet. 1986; 1: 825
        • Treutner K.H.
        • Bertram P.
        • Lerch M.M.
        • et al.
        Prevention of postoperative adhesions by single intraperitoneal medication.
        J Surg Res. 1995; 59: 764
        • Kenyon A.J.
        • Hamilton S.G.
        • Douglas D.M.
        Controlled wound repair in guinea pigs, using antimicrobials that alter fibroplasia.
        Am J Vet Res. 1986; 47: 96
        • Buckenmaier 3rd, C.C.
        • Pusateri A.E.
        • Harris R.A.
        • et al.
        Comparison of antiadhesive treatments using an objective rat model.
        Am Surg. 1999; 65: 274
        • Whang S.H.
        • Astudillo J.A.
        • Sporn E.
        • et al.
        In search of the best peritoneal adhesion model: comparison of different techniques in a rat model.
        J Surg Res. 2011; 167: 245
        • Cahill R.A.
        • Wang J.H.
        • Redmond H.P.
        Enteric bacteria and their antigens may stimulate postoperative peritoneal adhesion formation.
        Surgery. 2007; 141: 403
        • Marques Batista C.A.
        • Colleoni Neto R.
        • Lopes Filho G.J.
        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
        • Hong J.H.
        • Choe J.W.
        • Kwon G.Y.
        • et al.
        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
        • Bates Jr., G.W.
        • Shomento S.
        Adhesion prevention in patients with multiple cesarean deliveries.
        Am J Obstet Gynecol. 2011; 205: S19
      1. 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.

        • Yelian F.D.
        • Shavell V.I.
        • Diamond M.P.
        Early demonstration of postoperative adhesions in a rodent model.
        Fertil Steril. 2010; 93: 2734
        • Saed G.M.
        • Diamond M.P.
        Modulation of the expression of tissue plasminogen activator and its inhibitor by hypoxia in human peritoneal and adhesion fibroblasts.
        Fertil Steril. 2003; 79: 164
        • Rout U.K.
        • Saed G.M.
        • Diamond M.P.
        Expression pattern and regulation of genes differ between fibroblasts of adhesion and normal human peritoneum.
        Reprod Biol Endocrinol. 2005; 3: 1
        • Jiang Z.L.
        • Fletcher N.M.
        • Diamond M.P.
        • et al.
        Hypoxia regulates iNOS expression in human normal peritoneal and adhesion fibroblasts through nuclear factor kappa B activation mechanism.
        Fertil Steril. 2009; 91: 616
        • Sarada S.
        • Himadri P.
        • Mishra C.
        • et al.
        Role of oxidative stress and NFkB in hypoxia-induced pulmonary edema.
        Exp Biol Med. 2008; 233: 1088
        • Taylor N.W.
        The magnetic properties of odd molecules.
        J Am Chem Soc. 1926; 48: 854
        • Bennet J.E.
        • Ingram D.J.E.
        • Schonland D.
        Paramagnetic resonance spectra of the alkali superoxides and chlorine dioxide.
        Proc Phys Soc. 1956; 69: 556
      2. Kross RD Wound disinfection and repair. United States Patent 5,622,725; April, 1997.