Intra-abdominal use of taurolidine or heparin as alternative products to an antiadhesive barrier (Seprafilm (R)) in adhesion prevention: An experimental study on mice

Abstract

PURPOSE: Seprafilm (R) (Genzyme Biosurgery, Cambridge, MA) remains a widely used product in postoperative adhesion prevention. This study was designed to compare the antiadhesive effects of taurolidine, heparin, and Seprafilm (R) in a murine cecal abrasion model. METHODS: Sixty male Balb/c mice underwent a cecal abrasion procedure and were randomized into four groups (n=15 in each). Groups T, H, and S animals intraperitoneally received taurolidine, heparin, and Seprafilm (R), respectively, and Group C animals were reserved as control. Animals were killed on Day 21, and the severity of adhesions was evaluated with a scoring system ranging between 0 to 5. In addition, the localizations of the adhesions were questioned. RESULTS: Five (1 in Group S and 4 in Group H) animals died before they were killed. The deaths were related to intra-abdominal bleeding, and mortality rate was significantly higher in Group H than those in other groups (P < 0.05 for each comparison). The severity of adhesions was significantly less in the study groups than Group C, and in Group H than Groups T and S (P < 0.05 for each comparison). In addition, adhesions located cecum over itself were significantly less in the study groups than the control group, and those between small bowel and cecum were significantly lower in Groups T and S than the control group (P < 0.05 for each comparison). CONCLUSIONS: All products are effective in adhesion prevention. Heparin use provides the best results but may be associated with a higher mortality rate related to intra-abdominal bleeding. Taurolidine may be an alternative product to Seprafilm (R), but further studies are required.