Preventing intraperitoneal adhesions with ethyl pyruvate and hyaluronic acid/carboxymethylcellulose: a comparative study in an experimental model

Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181:1-5. doi: 10.1016/j.ejogrb.2014.07.004. Epub 2014 Jul 30.

Abstract

Objective: To compare the effectiveness of ethyl pyruvate (EP) with that of hyaluronic acid+carboxymethyl cellulose (Seprafilm) for the prevention of intraperitoneal adhesions. Seprafilm has been shown to be effective in many experimental and clinical studies.

Study design: Thirty rats were divided into three groups at random, and uterine horn abrasion was performed by laparotomy. One group received no treatment (control group), one group received a single intraperitoneal dose of EP 50mg/kg (EP group), and a 2×1-cm patch of Seprafilm was applied in the third group (Seprafilm group). All rats were killed 14 days after surgery. Macroscopic and histopathological evaluation were performed by a surgeon and a pathologist who were blinded to group allocation. Histopathologically, inflammation, fibroblastic activity, foreign body reaction, collagen proliferation, vascular proliferation, Masson-Trichrome score, matrix metalloproteinase-2 score and vascular endothelial growth factor score were studied.

Results: Median macroscopic intraperitoneal adhesion scores for the control, EP and Seprafilm groups were 2.8, 1.2 and 1.1, respectively. Multiple comparisons between groups showed a significant difference (p<0.05). In binary comparisons, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.05). No significant difference was found between the adhesion scores for the EP group and the Seprafilm group (p>0.05). After histopathological evaluation, significant differences in all parameters were found between the groups (p<0.05). In the paired comparison, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.0167), but no significant difference was found between the EP group and the Seprafilm group (p>0.0167).

Conclusions: In comparison with the untreated control group, EP and Seprafilm were found to reduce the formation of intraperitoneal adhesions. No significant difference was found between EP and Seprafilm.

Keywords: Ethyl pyruvate; Hyaluronic acid+carboxymethyl cellulose; Intraperitoneal adhesion.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Female
  • Hyaluronic Acid / therapeutic use*
  • Matrix Metalloproteinase 2 / analysis
  • Peritoneal Cavity
  • Peritoneal Diseases / metabolism
  • Peritoneal Diseases / pathology*
  • Peritoneal Diseases / prevention & control*
  • Pyruvates / therapeutic use*
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Single-Blind Method
  • Tissue Adhesions / metabolism
  • Tissue Adhesions / pathology
  • Tissue Adhesions / prevention & control
  • Vascular Endothelial Growth Factor A / analysis

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Pyruvates
  • Seprafilm
  • Vascular Endothelial Growth Factor A
  • ethyl pyruvate
  • Hyaluronic Acid
  • Matrix Metalloproteinase 2