Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

The Effect of Hyaluronic Acid and Vitamin I Combination on Preventing Postoperative Intraperitoneal Adhesion Formation in Dogs

개에서 Hyaluronic Acid와 Vitamin E의 병용이 복강수술 후 유착방지에 미치는 효과

  • Bae, Jae-Sung (College of Veterinary Medicine Kyungpook National University) ;
  • Jang, Kwang-Ho (College of Veterinary Medicine Kyungpook National University) ;
  • Kwon, Young-Sam (College of Veterinary Medicine Kyungpook National University) ;
  • Jang, Hwan-Soo (College of Veterinary Medicine Kyungpook National University) ;
  • Kim, Jung-Eun (College of Veterinary Medicine Kyungpook National University) ;
  • Park, Se-Il (College of Veterinary Medicine Kyungpook National University) ;
  • Lim, Jae-Hyun (College of Veterinary Medicine Kyungpook National University) ;
  • Li, Wen-Xue (College of Veterinary Medicine Kyungpook National University) ;
  • Lee, Seoung-Jin (College of Veterinary Medicine Kyungpook National University)
  • Published : 2003.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

This study was performed to compare the effect of hyaluronic acid(HA), vitamin I and their combinations for the prevention of postoperative intraperitioneal adhesion in dogs. Twelve mongrel dogs were divided into four groups; HA- (HA Group), vitamin E 800IU- (E8 Group), HA + vitamin E 800IU- (HA+E8 Group) and HA + vitamin E 1600IU-treated group(HA+E16 Group) with three dogs in each group. After celiotomy, five abrasions of 1$\times$1 cm area were made on the antimesenteric serosal surface of the anterior ileocecum with a No. 10 scalpel blade. The five abrasions and peritoneal cavity were coated with 25 of 0.l% HA. Oral supplements of vitamin E were given from the fifth day before the operation to the fourteenth day after the operation. Hematologic values were evaluated before the operation and on the 1st, 4th, 7th and 14th day after the operation. The locations and scores of adhesion were assessed through the second operation on the 21st day after the first operation. The adhesions were located on serosa to mesentary(43.3%)), serosa to serosa(20%), serosa to omentum(5%) and serosa to parietal peritoneum(1.7%). The incidences of adhesion in HA, E8, HA+E8 and HA+E16 groups were 80%, 100%, 47% and 53%, respectively. The scores of adhesion in HA+E8 group(p < 0.05) were lower than those in other groups. This study showed that the combination of HA and vitamin E 800IU was significantly effective in reducing the intraperitoneal adhesion in dogs.

개에서 hyaluronic acid(HA), vitamine E 및 두 약물의 병용이 복강수술 후 유착방지에 미치는 효과를 비교하고자 본 실험을 실시하였다. 실험견은 HA 처치군, Vitamin E 800 처치군, HA와 Vitamin E 800 처치군 그리고 HA와 Vitamin E 1600 처치군의 5개군으로 분류하고 각 군에 3두씩 배치하였다. 정중개복 후 회맹연접부를 확인하고 회장 쪽으로 5cm 간격으로 5곳에 1$\times$1cm 크기로 찰과상을 유도하였다. HA는 0.1%로 하나의 찰과상 당 3ml과 복강 내에는 체중 당 3ml을 도포하였다. Vitamin E 는 수술 전 5일부터 수술 후 14일까지 800, 1600IU의 용량으로 경구투여 하였다. 수술 3주 후에 유착발생빈도 및 정도를 평가하였다. 혈액학적 검사소견 상 WBC의 수치는 수술 1일 후 전군에서 최고치를 나타냈으나 4일 후부터는 감소하기 시작하여 14일에는 정상범위로 회복하였으며 전군에 있어서 유의적인 변화는 나타나지 않았다. Fibrinogen 수치는 수술 1일 후 전군에서 최고치를 나타냈으나 4일 후부터는 감소하기 시작하여 7일에 수술전 수치로 회복하였으며 전군에 있어서 유의적인 변화는 나타나지 않았다. 유착발생 장소는 장막-장간막(43.3%), 장막-장막(20%), 장막-대망막(5%), 장막-복막(1.7%) 순으로 발생하였다. 유착발생빈도는 HA와 Vitamin E 800 처치군 47%로 Vitamin E 800 처치군 100%, HA 처치군 80%, HA와 Vitamin E 1600 처치군 53%에 비해 낮았다. 유착형성은 HA처치군, Vitamin E 800 처치군, HA와 Vitamin E 800 처치군 그리고 HA와 Vitamin E 1600 처치군에서 5.3$\pm$0.58, 7$\pm$1.00, 2.3$\pm$1.15과 3$\pm$1.00로 HA와 Vitamin E 800 처치군이 유의적인 감소를 보였다(p<0.05). 이상의 결과를 종합하면 복강수술 후 유착방지에 있어 HA와 800 IU Vitamin E 병용투여가 효과적이라고 사료된다.

Keywords

References

  1. Textbook of small animal surgery(2nd ed.) Peritoneum and peritoneal cavity Crowe DT Jr;Bjorling DE
  2. J Surg Res v.61 Effects of hyaluronic Acid on fibroblast behavior in peritoneal injury Klein ES;Asculai SS https://doi.org/10.1006/jsre.1996.0149
  3. J Vet Clin Med v.14 Prevention of abdominal readhesions by sodium carboxymethylcellulose in dogs with abdominal adhesions Cheong J;Lee K;Jang K
  4. Surgery v.11 The prophylaxis of peritoneal adhesions. a review of the literature Boys F
  5. Surgery v.109 Beneficial actions of exogenous hyaluronic acid on wound healing King SR;Hickersin WL;Proctor KG
  6. Biochem J v.239 Increased hyaluronate synthesis is required for fibroblast detachment and mitosis Brecht M;Mayer U;Schlosser E;Prehm P https://doi.org/10.1042/bj2390445
  7. J Surg Res v.101 Polyanionic polysaccharides reduce intra-abdominal adhesion and abscess formation in a rat peritonitis medel Reijnen, Michel MP https://doi.org/10.1006/jsre.2001.6288
  8. Human Reproduction v.13 Clinical evaluation of 0.5% ferric hyaluronate adhesion prevention gel for the reduction of adhesions following peritoneal cavity surgery: open-label pilot study Thornton, Melvin H;Douglas B https://doi.org/10.1093/humrep/13.6.1480
  9. Fertil Steril v.68 Reduction of adhesion formation by postoperative administration of ionically cross-linked hyaluronic acid Johns DS;Kiorpes TC;Rodgers KE;DiZerega GS;Donahue WD https://doi.org/10.1016/S0015-0282(97)81472-0
  10. Fertil Steril v.69 Reduction of postsurgical adhesion formation in the rabbit uterine horn model with use of hyaluronate/carboxymethylcellulose gel Leach RE;Burns JW;Dawe EJ;SmithBarbour MD;Diamond MP https://doi.org/10.1016/S0015-0282(97)00573-6
  11. Fertil Steril v.70 A barrier composed of chemical cross-linked hyaluronic acid(Incert) reduces postoperative adhesion formation Haney AF;Doty E https://doi.org/10.1016/S0015-0282(98)00116-2
  12. J urg Res v.68 Prevention of postoperative pericardial adhesions using tissue-protective solution Seeger;James M;Kaelin
  13. Nature v.216 Anti-inflammatory activity of da-Tocopherol vitamin E) and linoleic acid Stuyvesant VW;Jolley W https://doi.org/10.1038/216585a0
  14. Ann Surg v.175 Inhibitory effect of vitamin E on collagen synthesis and wound repair Ehrleich H;Tarver H;Hunt TK https://doi.org/10.1097/00000658-197202000-00013
  15. Arch Surg v.120 The effect of vitamin E on experimentally induced peritoneal adhesions in mice Kagoma P;Burer SN;Seifter E;Levenson SM;Demetriou AA https://doi.org/10.1001/archsurg.1985.01390320073015
  16. J Reprod Med v.39 Efficacy of intraperitoneal sodium carboxymethylcellulose in preventing postoperative adhesion formation Heidrick GW;Pippitt CH;Morgan MA;Thurnau GR
  17. Br J Surg v.61 Observation on the pathogenesis of peritoneal adhesions : a light and electron microscopical study Milligan DW;Raftery AT https://doi.org/10.1002/bjs.1800610406
  18. Br J Surg v.52 The healing of peritoneum under normal and abdominal conditions Ellis H;Harrison W;Hugh TB https://doi.org/10.1002/bjs.1800520616
  19. Arch Surg v.98 Oxyphenbutazone anti-inflammatory agent in prevention of peritoneal adhesions Kapur BML;Talwa JR;Gulati SM https://doi.org/10.1001/archsurg.1969.01340090077010
  20. Modern Rheuma v.12 Comparison of the inhibitory effects of two types of hyaluronic acid on the expression of fibrinolytic factors in human synovial fibroblasts Nanaka;Tohgo;Hiraku https://doi.org/10.1007/s101650200027
  21. Cell Biology Int v.25 Effect of hyaluronan on MMP expression and activation Isnard N;Legeais JM;Renard G https://doi.org/10.1006/cbir.2001.0759
  22. Surg Clin North Am v.77 Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers Alexander H;DiZerega GS https://doi.org/10.1016/S0039-6109(05)70574-0
  23. J Surg Res v.55 Prevention of postoperative abdominal adhesions by tissue precoating with polymer solutions Yaacobi Y;Israel AA;Goldberg EP https://doi.org/10.1006/jsre.1993.1163
  24. Pediatr Surg Int v.15 Hyaluronate, tetrachlorodecaoxide, and galactolipid prevent adhesions after implantation of Gore-Tex and dura mater into the abdominal wall in rats Schier F;Danzer M https://doi.org/10.1007/s003830050570
  25. J Biomed Materials Res v.42 Reduction of fibrous adhesion formation by a copolymer possessing an affinity for anionic surfaces Elbert, Donald L https://doi.org/10.1002/(SICI)1097-4636(199810)42:1<55::AID-JBM8>3.0.CO;2-N
  26. Human Reproduction v.15 Development of a novel glucose polymer solution for adhesion prevention Verco;Shelagh JS;DiZerega https://doi.org/10.1093/humrep/15.8.1764
  27. Fertil Steril v.41 Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat Elkins TE;Bury RJ;Ahokas RA;Malinark LR https://doi.org/10.1016/S0015-0282(16)47909-4
  28. Fertil Steril v.61 Contemporary adhesion prevention Dizerega GS https://doi.org/10.1016/S0015-0282(16)56507-8
  29. Fertil Steril v.43 Potential for in vitro growth of common bacteria in solutions of 32% dextran 70 and 1.0% sodium carboxymethylcellulose Elkins TE;Trenthem L
  30. Acta Obstet gynecol Scand v.73 Synergistic effects of carboxymethyl-cellulose and molecular weight heparine in reducing adhesion formation in the rat uterine horn model Sahin Y;Saglam A https://doi.org/10.3109/00016349409013399
  31. I Fertil Steril v.41 Adhesion prevention by solutions of sodium carboxymethylcellulose in the rat Elkins TE;Bury R;Ritter J;Ling F;Ahokas R;Homsey C;Malinak LR https://doi.org/10.1016/S0015-0282(16)47909-4
  32. Am J Clin Nutr v.48 Safety of oral intake of vitamin E Bendich A;Machlin LJ https://doi.org/10.1093/ajcn/48.3.612
  33. Surgery v.114 Prevention of peritoneal adhesions by administration of sodium carboxymethyl cellulose and oral vitamin E Hemadeh O;Chilukuri S;Bonet V;Hussein S;Chaudry IH
  34. J Reprod Med v.40 Effect of vitamin E on adhesion formation Sanfilippo JS;Booth RJ;Burns CD
  35. Arch Bioche and Biophy v.334 Vitamin E slows the rate of free radical-mediated lipid peroxidation in cells Brett AW;Garry RB https://doi.org/10.1006/abbi.1996.0454
  36. Platelets v.12 Effects of -Tocopherol on platelets and the coagulation system Irina B;David G;Thomas R
  37. Arterioscler Thromb Vasc Biol v.19 Vitamin E inhibits collagen-induced platelet activation by blunting hydrogen peroxide Pasquale P;Fabio MP;Luisa L https://doi.org/10.1161/01.ATV.19.10.2542
  38. Am J Hematol v.65 Vitamin E reduces platelet adhesions to human endothelial cells in vitro Szuwart T;Brzoska T;Luger T https://doi.org/10.1002/1096-8652(200009)65:1<1::AID-AJH1>3.0.CO;2-8
  39. Ann Surg v.196 Role of platelet and fibrin in the healing sequence Knighton DR;Hunt TK;Thakral KK;Goodson WH https://doi.org/10.1097/00000658-198210000-00001
  40. Br J Surg v.69 The causes and prevention of intestinal adhesions Ellis H https://doi.org/10.1002/bjs.1800690502