Comparison of the two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats.

Purpose: The aim of this study was to evaluate the efficacy of two absorbable film barriers, polylactic acid and sodium hyaluronate-carboxymethyl cellulose, in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model.

Methods: Forty Wistar albino rats were grouped as polylactic acid, sodium hyaluronate-carboxymethyl cellulose, and control. All rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. The two treatment groups received polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers, while control group received nothing. On postoperative day 21, three observers graded the intra-abdominal adhesions and resected specimens. Fibrosis, inflammation, and adhesions were graded using quantitative scoring systems.

Results: When compared to control group, polylactic acid group showed significantly less inflammation and adhesion (p < 0.005), while there was no significant difference for fibrosis. Sodium hyaluronate-carboxymethyl cellulose group has showed significantly less adhesions (p < 0.005), but there were no significant differences among fibrosis and inflammation when compared to control group. There were no significant differences between polylactic acid and sodium hyaluronate-carboxymethyl cellulose groups on adhesion formation, inflammation, or fibrosis.

Conclusions: Placement of polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers between injured surfaces is associated with a significantly reduced rate of postoperative adhesions. No superiority was detected between two barriers.