METHYLENE BLUE AND CARBOXYMETHYL CELLULOSE-SODIUM HYALURONIC ACID IN THE PREVENTION OF POSTOPERATIVE INTRAPERITONEAL ADHESIONS
CENGİZ ERENOĞLU, MEHMET LEVHİ AKIN, HALDUN ULUUTKU, GÜLTEKİN ERDOĞAN, ŞÜKRÜ YILDIRIM, AHMET BATKIN
GATA Haydarpaşa Eğitim Hastanesi, Genel Cerrahi ve Patoloji Servisi, İSTANBUL
The aim of this study is to assess the preventive effects of methylene blue (MB) and carboxymethyl cellulose-sodium hyaluronic acid (CMC+SHA) in postoperative intraabdominal adhesions in an animal model. No therapeutic method has been completely successful to prevent postoperative intraabdominal adhesions and their complications, Rats were separated into three groups of 10 rats. Under anaesthesia, all rats had a midabdominal laparotomy. A serosal incision of 2cm on caecal serosa and 1x1 cm of peritoneal extirpation including muscle layer lateral to laparotomy incision was made, and defects were repaired using 4/0 silk sutures. in control group only 2ml of normal saline, and in MB group 2ml of MB were administrated intraperitoneally, in CMC+SHA group abdominal content was covered by a film of CMC-t-SHA. Abdominal wound was ciosedin two layers. On the postoperative 14th day all rats were sacrificed and intraabdominal adhesions were evaluated both macroscopically and microscopically, Macroscopically, postoperative adhesion formations in MB and CMS+SHA groups were significantly lower than that of control group (p<0,05X while there was no significant difference between MB and CMC+SHA groups. Microscopically giant cell reaction, fat necrosis, granulation tissue formation and fibrosis in MB group were significantly lower (p<0,05) than those of control group, while only granulation tissue formation and fibrosis in CMC+SHA group were significantly lower (p<0,05) than those of control group. it is concluded that both MB and CMC+SHA are effective in the prevention of postoperative peritoneal adhesions. However, MB may be a better choice because it is cheaper, easy to use, and it does not have any toxic or side effects.
Keywords: İNTRAABDOMINAL ADHESION, METHYLENE BLUE, CARBOXYMETHYL CELLULOSE-SODIUM HYALURONIC ACID