Preventive effect of carboxymethyl chitosan solution on postoperative peritoneal adhesions in a rat model

Cui Juan-juan; Feng Zhan-qin; Zhang Shou-qiang; Zheng Zeng-juan; Zhang Wei-fen

doi:10.3969/j.issn.2095-4344.2014.08.017

Abstract：BACKGROUND:The patients are suffering from peritoneal adhesions that are caused after abdominal operation. As so far, there is stil no effective drug or method that can completely prevent peritoneal adhesions. Carboxymethyl chitosan is a biocompatible and biodegradable biomedical material with anti-adhesion effects, which is an ideal biomaterial for prevention of peritoneal adhesion theoreticaly. <br> OBJECTIVE:To investigate the novel anti-adhesion properties of carboxymethyl chitosan anti-adhesion solution on the prevention of postsurgical adhesion in vivo in a rat model. <br> METHODS:Fifty-six adult male Wistar rats were randomly divided into four groups: 0.9% normal saline solution (group A), hyaluronic acid gels (group B), medical chitosan gels (group C) and carboxymethyl chitosan anti-adhesion solution (group D). The model of postoperative intestinal adhesion was established by making cecal scratches/abdominal wal defects. Al the rats were scarified after 2 or 3 weeks. Whole blood was colected by cardio-puncture, lung tissue and tissue adhesion were stripped. The incidence and degree of adhesions, histological effects, expression of transforming growth factor-β1 (TGF-β1), the amounts of hydroxyproline and white blood cels were observed. <br> RESULTS AND CONCLUSION:The formation of postsurgical adhesions in groups B, C and D was significantly decreased, which was lighter than that of group A (P < 0.05). Furthermore, the adhesion formation in group D was significantly decreased in comparison with group A (P < 0.01). At the same time, the levels of transforming growth factor-β1, hydroxyproline and white blood cels in group D were lighter than those of group A (P < 0.05), and the histopathological results indicated that a marked reduction in inflammatory cels and fibroblasts. Carboxymethyl chitosan anti-adhesion solution can effectively reduce the degree and incidence of postoperative adhesion, and it is becoming a promising drug delivery system in the context of postsurgical anti-adhesion.