Liquid Paraffin vs Hyaluronic Acid in Preventing Intraperitoneal Adhesions

Abstract

Adhesion formation after abdominal and pelvic operations remains a challenging problem. Role of adjuvant barriers have been studied but there is no comparative study between liquid paraffin and hyaluronic acid as a barrier method. Hence, we planned to compare the effectiveness of 0.4 % hyaluronic acid and liquid paraffin in the prevention of postoperative intraperitoneal adhesions in rats. This prospective, randomized and controlled study was conducted in 60 adult Wistar albino rats. Surgical trauma by caecal abrasion and 1 g talcum powder was used in the rat model to induce adhesion formation. After trauma, 3 ml normal saline was instilled in the peritoneal cavity in control group ( = 20), 3 ml liquid paraffin was instilled in experimental group A ( = 20) and 3 ml 0.4 % hyaluronic acid was instilled in experimental group B ( = 20). Two weeks after laparotomy, repeat laparotomy was performed and the adhesions were scored according to Zuhlke classification. Liquid paraffin and hyaluronic acid both reduce the extent and grade of adhesions both macroscopically ( = 0.018, = 0.017) and microscopically ( = 0.019, = 0.019) respectively. Although there was significant reduction in adhesions by hyaluronic acid at certain specific sites as compared with liquid paraffin, its overall effectiveness in preventing postoperative intraperitoneal adhesions is not significantly different from liquid paraffin ( = 0.092, = 0.193) respectively. The presence of liquid paraffin and hyaluronic acid in the peritoneal cavity reduce postoperative intraperitoneal adhesions significantly in rats. However, there is no overall significant difference in the effectiveness of two groups. Dosage and safety of these chemicals in human beings remains to be established.

Experimental fortification of intestinal anastomoses with nanofibrous materials in a large animal model

“…www.nature.com/scientificreports www.nature.com/scientificreports/ The amount of postoperative adhesions in the peritoneal cavity has been successfully decreased both experimentally and clinically using different substances, usually in a form of gel. Hyaluronic acid based gels or also polycaprolactone based gels can serve as examples 31,[49][50][51] ; however, the influence of such materials on the anastomotic healing has not been described and therefore cannot be considered safe in our application.…”

Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-23460 | DOI: 10.14744/tjtes.2020.23460 Boric acid is as effective as hyaluronic acid-based agent in preventing intraabdominal adhesions in a rat model

“…Fibrinolytic agents, anti-inflammatory agents, antibiotics, crystalloids, hydrogen-rich saline, icodextrin, liquid paraffin, mitomycin-C, phospholipids, and even honey have been evaluated, in most experimental studies for their anti-adhesion properties. [15,16,[21][22][23][24][25][26][27] A more recent experimental study found thermosensitive hydrogel (xyloglucan) effective in preventing early-onset intra-abdominal adhesions. [28] Bletilla striata, Chinese medicinal herb, is found promising in alleviating inflammatory process and reducing the formation of abdominal adhesions.…”

Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies

“…One study showed that applying 0.1% sodium HA in a canine model caused no clinically significant pericardial adhesions compared to 1% carboxymethyl cellulose, which had 20% adhesions [231]. In another study, HA was compared to paraffin in preventing intra-peritoneal adhesions in rats and found no significant difference between the two, although the presence of both significantly reduced adhesion formation [232].…”