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Reduced postoperative intra-abdominal adhesions using Carbylan-SX, a semisynthetic glycosaminoglycan hydrogel

Fertil Steril. 2007 Apr;87(4):940-8. doi: 10.1016/j.fertnstert.2006.07.1532. Epub 2006 Dec 8.

Abstract

Objective: To compare the efficacy of crosslinked Carbylan-SX (Carbylan BioSurgery, Inc., Palo Alto, CA) hydrogel films and sprayable gels as physical barriers in reducing postoperative intra-abdominal adhesions in the rat cecum-abdominal wall and rat uterine horn models.

Design: Pre-formed crosslinked Carbylan-SX films and sprayable in situ crosslinkable Carbylan-SX gels were evaluated in rat cecum-abdominal wall and rat uterine horn models and compared with commercially available and clinically used Seprafilm.

Setting: University animal research facility.

Animals: Female Wistar rats.

Intervention(s): Abrasions were made with the foot-pedal-operated Flex-shaft (Dremel, Racine, WI) on both the cecum and abdominal wall (each area 10 mm in diameter) in female rats as one model and on both uterine horns (3 x 10 mm) in female rats as the other model. In each of the two adhesion models, four groups were assigned with eight rats in each group: (1) untreated control, (2) treated with Seprafilm (Genzyme Corporation, Cambridge, MA), (3) treated with preformed Carbylan-SX hydrogel films, and (4) treated with sprayable Carbylan-SX gel.

Main outcome measure(s): Extent and severity of postoperative adhesions between the cecum and the abdominal wall in rat cecum-abdominal wall model and between the uterine horns in rat uterine horn model.

Result(s): The Carbylan-SX film and the Carbylan-SX sprayable gel led to fewer adhesions than Seprafilm in both rat adhesion models. Interestingly, a single physical form was not optimal for both models: the Carbylan film was more efficacious in the rat uterine horn model, whereas Carbylan gel gave the best results in the rat cecum-abdominal wall model.

Conclusion(s): Both Carbylan-SX film and gel were efficacious in reducing postoperative intra-abdominal adhesion formation in rat cecum-abdominal wall and uterine horn models.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Abdominal Wall
  • Animals
  • Cecal Diseases / prevention & control
  • Female
  • Gelatin / therapeutic use*
  • Hyaluronic Acid / analogs & derivatives*
  • Hyaluronic Acid / therapeutic use
  • Postoperative Complications / prevention & control*
  • Rats
  • Rats, Wistar
  • Tissue Adhesions / prevention & control*
  • Uterine Diseases / prevention & control
  • Uterus / surgery

Substances

  • Seprafilm
  • carbylan-GSX
  • Gelatin
  • Hyaluronic Acid