Choice of Hemostatic Agent Influences Adhesion Formation in a Rat Cecal Adhesion Model

Nathan E. Hoffmann, Sameer A. Siddiqui, Shvetank Agarwal, Stephen H. McKellar, Harold J. Kurtz, Matthew T. Gettman, Mark H. Ereth

Research output: Contribution to journalArticle

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Abstract

Introduction: Hemostatic agents are frequently used during abdominal surgery and some are linked to adhesion formation. We sought to evaluate the impact of several commonly used hemostatic agents on adhesion formation in a rat peritoneal model. Methods: In our study, Wister outbred rats underwent laparotomy and excision of a portion of their peritoneum to initiate adhesion formation process. One of six different hemostatic agents, namely, activated starch microspheres (Arista AH; Medafor Inc., Minneapolis, MN), glutaraldehyde activated collagen (BioGlue; Cryolife Inc., Kennesaw, GA), thrombin coated collagen microspheres (FloSeal; Baxter Inc., Deerfield, IL), thrombin activated fibrin polymer (Tisseel, Baxter), polyethylene glycol polymer (CoSeal, Baxter), or oxidized cellulose (Surgicel; Ethicon Inc., Somerville, NJ), was placed in the area of peritoneal defect. All animals were sacrificed on post-op day 7 and strength and extent of adhesion formation was determined. Histopathological examination of rat caecum was also performed. Results: Arista and CoSeal showed significantly lower adhesion formation than controls (P < 0.05). Higher adhesion scores were seen in BioGlue (P < 0.05) treated rats. Additionally, histopathologic examination showed that BioGlue caused statistically more inflammation and necrosis than controls (P < 0.05). Total adhesion score increased with residual amount of agent present at 7 d. Conclusions: Use of Arista and CoSeal may help in reducing peritoneal adhesions after intra-abdominal surgeries. Furthermore, there appears to be a relationship between the creation of inflammation and necrosis in tissues and the eventual formation of adhesions. This could aid in improving the design of these agents in the future.

Original languageEnglish (US)
Pages (from-to)77-81
Number of pages5
JournalJournal of Surgical Research
Volume155
Issue number1
DOIs
StatePublished - Jul 1 2009
Externally publishedYes

Fingerprint

Hemostatics
Microspheres
Thrombin
Polymers
Necrosis
Collagen
oxidized cellulose
Inflammation
Fibrin Tissue Adhesive
Peritoneum
Glutaral
Fibrin
Starch
Laparotomy
Arista
Bio-glue
CoSeal

Keywords

  • adhesion
  • hemostatic agents
  • rat peritoneal model

ASJC Scopus subject areas

  • Surgery

Cite this

Hoffmann, N. E., Siddiqui, S. A., Agarwal, S., McKellar, S. H., Kurtz, H. J., Gettman, M. T., & Ereth, M. H. (2009). Choice of Hemostatic Agent Influences Adhesion Formation in a Rat Cecal Adhesion Model. Journal of Surgical Research, 155(1), 77-81. https://doi.org/10.1016/j.jss.2008.08.008

Choice of Hemostatic Agent Influences Adhesion Formation in a Rat Cecal Adhesion Model. / Hoffmann, Nathan E.; Siddiqui, Sameer A.; Agarwal, Shvetank; McKellar, Stephen H.; Kurtz, Harold J.; Gettman, Matthew T.; Ereth, Mark H.

In: Journal of Surgical Research, Vol. 155, No. 1, 01.07.2009, p. 77-81.

Research output: Contribution to journalArticle

Hoffmann, NE, Siddiqui, SA, Agarwal, S, McKellar, SH, Kurtz, HJ, Gettman, MT & Ereth, MH 2009, 'Choice of Hemostatic Agent Influences Adhesion Formation in a Rat Cecal Adhesion Model', Journal of Surgical Research, vol. 155, no. 1, pp. 77-81. https://doi.org/10.1016/j.jss.2008.08.008
Hoffmann, Nathan E. ; Siddiqui, Sameer A. ; Agarwal, Shvetank ; McKellar, Stephen H. ; Kurtz, Harold J. ; Gettman, Matthew T. ; Ereth, Mark H. / Choice of Hemostatic Agent Influences Adhesion Formation in a Rat Cecal Adhesion Model. In: Journal of Surgical Research. 2009 ; Vol. 155, No. 1. pp. 77-81.
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