Purpose: We investigated the synergistic effect of hyperbaric oxygen (HBO) and granulocyte-colony stimulating factor (G-CSF) on adhesion formation in rats.
Methods: 40 adult male Sprague-Dawley rats (250-350 g) were divided into 4 groups. In group-1, no further management was undertaken. Group-2 received HBO therapy, group-3 was treated with 50 ug/kg subcutaneous G-CSF once daily for 7 days following laparatomy and cecal abrasion and group-4 was given both G-CSF and HBO therapies. On the 7th day, all rats were sacrificed and adhesions were scored. Tissue samples from adhesions and peritonea and cecum wall were examined both pathologically and biochemically for tissue hydroxyproline content.
Results: No mortality occurred in study groups. When the groups were evaluated according to the adhesion numbers and grades, there was a statistically significant difference between the control and groups 3 and 4 (P < 0.001). There was no statistically significant difference between groups 1 and 2 (p > 0.05). HBO + G-CSF group was significantly different from control, HBO and G-CSF groups, regarding hydroxyproline contents (p = 0.005). Inflammation and fibrosis did not differ significantly among the groups (p = 0.248), (p = 0.213).
Conclusion: HBO treatment could not reduce the adhesion formation alone. Combined use of HBO and G-CSF, has a markedly preventive effect on postoperative adhesion formation (Tab. 1, Fig. 2, Ref. 57).