Year 2017 Vol. 25 No 1




FSBRE "Irkutsk Scientific Center of Surgery and Traumatology",
The Russian Federation

Objectives. To assess the efficacy and safety of Adept drug for adhesion prevention in the abdominal cavity in the experiment.
Methods. A simulation method of adhesions in the abdominal cavity of experimental animals (male Wistar rats) was carried out by opening the serous-muscular layer of the caecum followed by closing the wound with Schmieden suture and scarification of the parietal peritoneum of the right lateral channel. On the 14th and 30th days 2 groups were studied: NaCl (3 ml) was injected into the peritoneal cavity of control group (n=10) and Adept drug (3 ml) was injected into the peritoneal cavity only once in the experimental group (n=10). Macroscopic scale for the adhesion process assessment was used as well as histological study of the adhesion area with haematoxylin and eosin staining and by Van Giesons stain.
Results. At the 14th day in the control group, the severity of adhesions 9 (6;9) (Me [Q25-Q75]) scores did not differ significantly comparing to experimental group 6 (3;8) scores). At the 30th day the severity of adhesions was assessed by 12 (9;13) scores vs. 7 (3;10) scores in the experimental group. By the method of multiple comparisons (2-tailed method) it was revealed that the severity of adhesions did not differ significantly on the 30th day (p = 0,609). Furthermore, in the experimental group the side effects of the Adept drug were registered: eosinophilic infiltration of the subserous layer (80%), the formation of the granulomatous inflammation with the large number of Pirogov-Langhans cells (20%). In one case the encapsulated omental abscess was found and in another case inflammatory infiltration of adhesion zone.
Conclusion. A single intraoperative application of Adept drug at a dose of 3 ml per rat is thought to be not enough effective for the prevention of adhesions in the experiment. It is noteworthy the application of Adept drug leads to side effects: severe eosinophilic infiltration of the adhesion area, granulomatous inflammation characterized by a large number of Pirogov-Langhans cells, the encapsulated omental abscess.

Keywords: postoperative peritoneal adhesions, omental abscess, Adept drug, Pirogov-Langhans cells, Icodextrin, inflammatory response, wound healing
p. 14-19 of the original issue
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Address for correspondence:
664003, the Russian Federation, Irkutsk,
Bortsov Revolutsi Str., 1,
Irkutsk Scientific Center of Surgery
and Traumatology,
Tel.: +7 395 229-03-69
Irina A. Shurygina
Information about the authors:
Shurygina I.A. MD, Professor of RAS, Deputy Director for Science, FSBRE "Irkutsk Scientific Center of Surgery and Traumatology".
Aushinova N.I. PhD, Senior Researcher of FSBRE "Irkutsk Scientific Center of Surgery and Traumatology".
Shurygin M.G. MD, Head of the scientific-laboratory department, FSBRE "Irkutsk Scientific Center of Surgery and Traumatology".
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