Background: Postoperative PERITONEAL ADHESION occurs in more than 90% of intra-abdominal surgeries and can lead to intestinal obstruction, infertility, abdominal and pelvic pain. The extract of Malva sylvestris has shown to be safe and non-toxic with a wide range of biological activities. Objectives: This study was designed to evaluate the effect of intraPERITONEAL nebulization of M. sylvestris in the healing process of postoperative intra-abdominal ADHESION for the first time. Methods: For creating intra-abdominal ADHESIONs, the rats were anesthetized to undergo surgery. Four lavage solutions including saline, ethanolic extract, hydroalcoholic extract, and aqueous extract of M. sylvestris were used for 2 min, and then the abdomen was closed. After 15 days, the rats underwent surgery and cecum and PERITONEAL samples were obtained for histopathological analysis. The severity of PERITONEAL ADHESIONs based on the histopathological analysis and serum levels of TNF- and Il-1 were compared in different groups. Results: The aqueous and hydroalcoholic extracts of M. sylvestris decreased significantly microscopic and macroscopic PERITONEAL ADHESION while the ethanolic extract just reduced it microscopically. The aqueous and hydroalcoholic extracts were more potent than the ethanolic extract in the healing process. The concentrations of inflammatory biomarkers including IL-1 and TNF- did not change significantly. Conclusions: The extract of M. sylvestris could decrease the severity of PERITONEAL ADHESION compared to the control group but it could not decrease the level of systemic inflammatory mediators.

Background: PERITONEAL ADHESION is a critical postsurgical complication in abdominal and pelvic surgeries. Due to their anti-inflammatory and fibrinolytic properties, statins are assumed to reduce PERITONEAL ADHESIONs effectively. Our study aimed to investigate the effects of atorvastatin topical solution on preventing postoperative PERITONEAL ADHESION in rats.Methods: Twenty male Wistar rats were used, and a 2–3 cm ventral midline incision was made under general anesthesia. The cecal abrasion model was used for the induction of PERITONEAL ADHESION. Four groups of five rats were used: normal saline (negative control), hydrocortisone 1% (positive control), atorvastatin 1%, and atorvastatin 4%. All rats were sacrificed on the fifth postoperative day. The ADHESIONs were scored as 1 to 4 microscopically and 0 to 5 macroscopically. A histopathological study was performed on the cecum and adherent bands. A blood sample was also taken for high-sensitivity C-reactive protein (hs-CRP) analysis on day 5.Results: Histopathological evaluation showed that microscopic and macroscopic ADHESION significantly decreased after using atorvastatin 4% compared to the normal saline group (P = 0.032 and P = 0.008, respectively). Atorvastatin 4% also significantly reduced the level of hs-CRP after abdominal surgery (P = 0.001). The results with atorvastatin 1% were insignificant.Conclusion: Atorvastatin 4% topical solution effectively prevented rat PERITONEAL ADHESION, possibly through its anti-inflammatory effects. More extensive animal studies with atorvastatin and other statins and large human clinical trials are still needed to confirm the applicability and accuracy of the present findings.

Introduction: ADHESION formation after abdominal and pelvic surgery is a serious problem which can lead to bowel obstruction and chronic abdominal pain and female infertility. After PERITONEAL injury, histamine and other vasoactive kinines which secreted from inflammatory cells and fibroblasts induce PERITONEAL ADHESION formation. This study is designed according to the suppressing effect of dexamethasone on inflammatory cells and of mitomycin on fibroblast function.Materials and Methods: This experimental study was done in two stages. In the first stage, 60 rats were randomly divided in 6 groups. After laparatomy, PERITONEAL washing was done for 3 minutes with saline, mitomycin solutions (0.25 mg/cc, 0.5 mg/cc and 1 mg/cc), dexamethasone (0.3 mg/Kg), and dexamethasone (0.3 mg/Kg) plus mitomycin (0.5 mg/cc). Six weeks later, the second laparatomy was done and the incidence rate and severity of dhesions were evaluated. In the second stage of study, 90 rats in 6 groups were evaluated. The PERITONEAL cavities were washed with normal saline, mitomycin (0.25 mg/Kg, 0.5 mg/Kg and 1 mg/Kg), dexamethasone (0.3 mg/Kg), and mitomycin (0.5 mg/cc) plus dexamethasone (0.3 mg/Kg). Then ADHESION formation was evaluated same as first stage. Results: The study showed PERITONEAL washing with 0.25mg/cc, 0.5mg/cc and 1mg/cc of mitomycin solutions caused death of all animals. Mitomycin solutions at doses of 0.5 mg/Kg and 1 mg/Kg decreased the rate (P<0.02) and severity (P<0.047, P<0.013 respectively) of ADHESIONs. Dexamethasone did not decrease rate and severity of ADHESIONs.Conclusion: Mitomycin is effective in decreasing ADHESION band formation after abdominal surgery, but more studies are necessary for evaluating the side effects and suitable doses. In our study, dexamethasone did not any effect on the ADHESIONs, perhaps because of the different way of application.

BACKGROUND: ADHESIONs are common consequences of abdominal operations and they can cause significant complications such as bowel obstruction, infertility and abdominal pain. A wide variety of ADHESION-reducing substances have been evaluated but we are still far from the ideal ADHESION preventing agent. In this study, we decided to evaluate the effects of PERITONEAL exposure to beta dine and heparin in post-surgical ADHESIONs in rats. METHODS: A total of 39 male Wistar-Albino rats weighting 200-250 grams were randomly assigned to three groups. Anesthesia was performed using intramuscular ketamine and xylazine. After a midline laparotomy, enterotomy and repair, bowels were irrigated by saline 0.9%, heparinized saline and beta dine solution. Finally, ADHESIONs were evaluated and scored after 20 days. RESULTS: All groups were almost similar in mean ADHESION score in the site of enterotomy but mean total abdominal ADHESION score in beta dine group was significantly higher than those of other groups. According to pathological studies, PERITONEAL inflammation was more severe in the beta dine group but there wasn’t any statistically significant difference between frequency of foreign body reaction and wound healing stage among three groups. Surprisingly, anastomosis leakage was significantly more common in heparin group. CONCLUSIONS: To date, the most effective means of limiting ADHESIONs is a meticulous surgical technique although intraPERITONEAL irrigation with heparin seems to reduce ADHESIONs but further studies should be done to evaluate the effects of local administration of heparin on anastomosis leakage.

The objective of this study was to determine the effectiveness of topical administration of honey in prevention of or reduction in post-surgical PERITONEAL ADHESIONs in dog. The study was conducted on 18 adult female mixed-breed dogs with a mean ± SD weight of 20 ± 4.25 kg. A standardized surgical trauma (serosal trauma model) was made in the dogs’ descending colon to induce ADHESION formation. The control group (n = 9) received saline treatment. In the experiment group (n = 9), the lesions were covered with honey. Three weeks after laparotomy, the dogs were sacrificed and the ADHESIONs were graded according to the Evans’s scoring system. Overall, 67% (n = 6) of the control and 22% (n = 2) of the experiment animals presented with moderate (grade-2) and severe (grade-3) ADHESIONs. In the control group, there were 3 (33%) dogs with grade-0 or grade-1 ADHESIONs, while in the experiment group there were 7 (78%) dogs with the same grades of ADHESIONs. The difference between the two groups was significant (P<0.05). It was concluded that honey is a useful covering for damaged PERITONEAL surfaces and has high effectiveness in reducing post-operative ADHESIONs.