Exploring new therapeutic potentials of curcumin against post-surgical adhesion bands

Abstract

Background Adhesion band formation is a common cause of morbidity for patients undergoing surgeries. Anti-inflammatory and anti-fibrotic properties of curcumin, a pharmacologically active component of Curcuma longa, have been investigated in several studies. The aim of this study is to explore the therapeutic potential of curcumin in attenuating post-operative adhesion band (PSAB) formation in both peritoneal and peritendinous surgeries in animal models. Methods Bio-mechanical, histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin. Results Results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. Curcumin may decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models. Conclusion These results suggest that protective effects of phytosomal curcumin against PSAB formation is partially mediated by decreasing inflammation and fibrosis at site of surgery. Further studies are needed to investigate the therapeutic potential of this molecule in preventing PSAB.

Síndrome adherencial post quirúrgico fisiopatología, complicaciones y tratamiento

“…Las adherencias posquirúrgicas son consecuencia de la inhibición de la fibrinólisis, los depósitos de colágeno, la neovascularización y la disminución de la actividad del factor activador del plasminógeno. (11,12) Según su localización anatómica:(9)…”

“…La incidencia de adherencias es similar tanto si se reaproxima el peritoneo después de la laparotomía como si no se hace. (12,14) Aunque por lo general no es necesario cerrar el peritoneo parietal, en caso de ser necesario, se debe usar sutura absorbible fina. Los materiales de sutura como el poliglactin estimulan poca reactividad tisular y, por lo tanto, se prefieren en lugar de materiales más reactivos como las suturas de catgut cromado o seda.…”

“…Se han realizado varios estudios sobre la eficacia de las láminas de ácido hialurónico. (12,15,16) Un metaanálisis de ocho ensayos aleatorios en pacientes sometidos a cirugía intestinal mostró que el uso de estas sábanas reducía significativamente las adherencias intraabdominales. Sin embargo, no tuvieron impacto sobre la incidencia de obstrucción intestinal posoperatoria de hecho, el análisis reveló que el uso de láminas de ácido hialurónico aumentaba el riesgo de complicaciones sépticas como absceso abdominal y fuga anastomótica (7,17).…”