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Abstract
Purpose. The goal of this study was to determine the efficacy of a single intraperitoneal
administration of a chondroitin sulfate solution in preventing postoperative adhesion
formation.
Methods. Twenty-five Sprague–Dawley rats had a 1-cm2 area of cecal serosa abraded. Controls (CON, n = 5) received no treatment, the chondroitin sulfate group (CS, n = 10) received chondroitin sulfate (0.013 g/kg) in 0.9% NaCl intraperitoneally (ip),
and vehicle controls (VC, n = 10) received an equal volume of 0.9% NaCl solution ip before the abdomen was closed.
All animals were sacrificed on postoperative day 10. The extent of adhesion was quantified
according to Mazuji's adhesion grade (0 to 4: 0 = no adhesion and 4 = very dense adhesion)
and quantitated after H&E, trichome, and immunohistochemical staining for fibrin and
collagen type I and type III using digital image analysis.
Results. The mean Mazuji's adhesion grade in the CON was 4.0 ± 0.0, in the VC 2.60 ± 0.37,
and in the CS 1.3 ± 0.42 (P < 0.01 for CS vs CON and P < 0.05 for CS vs VC comparisons). The mean gray-scale intensity (0–255: 0 = dense
amount and 255 = none) of adhesion density in the CON was 105.5 ± 5.5, in the VC 125
± 15.0, and in the CS 178.3 ± 21.0 (P < 0.01 for CS vs CON and P < 0.05 for CS vs VC comparisons). The mean adjusted intensity stain indices (AISI)
for fibrin and collagen type I in the CON were 59 ± 17 and 53 ± 19, in the VC 27 ±
3 and 25 ± 7, and in the CS 16 ± 5 and 6 ± 3, respectively (P < 0.05 between CS and CON comparisons). The AISI of collagen type III was not significant
among all the groups (P > 0.1).
Conclusions. The extent of early postoperative intra-abdominal adhesion formation as determined
by gross assessment and from quantitation of fibrin and collagen type I deposition
was significantly reduced by a single intraperitoneal administration of a chondroitin
sulfate solution.
Keywords
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© 2000 Academic Press. Published by Elsevier Inc. All rights reserved.