The Effects of Poloxamer/Sodium Alginate Mixture Barriers on Prevention of Post-Operative Peritoneal Adhesion in Dogs

개에서 Poloxamer / Sodium Alginate 혼합물의 복강 유착 방지 효과

This study was performed to determine the effectiveness of poloxamer/sodium alginate mixture(PX/SA) barriers on prevention of post-operative peritoneal adhesion in dogs. Fifteen mongrel dogs were divided into three experimental groups: non-treated group, 2% Sodium Carboxymethylcellulose (SCMC) treated group and PX/SA treated group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogeneous petechial hemorrhagic surface over a 1 ${\times}$ 1 cm area. Solution of SCMC was allowed to spread across the intraperitoneal organs through a catheter using a syringe. PX/SA was simply coated over the abraded tissues. On day before and day 1, 4, 7, and 14 after operation, venous blood specimens were collected for measurement of RBC, total WBC and fibrinogen. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The RBC, total WBC and fibrinogen values of three groups showed no statistical significances. The mean tensile strength(gram force, gf) of formed adhesions on day 21 after surgery was 173.05${\pm}$113.48 in the non-treated group, 111.42 ${\pm}$ 38.25 in the SCMC group, and 69.00 ${\pm}$ 45.07 in the PX/SA group. The tensile strength values for adhesion seperation in PX/SA group was lower than those in SCMC group(p < 0.05) and significantly lower than those in the non-treated group(p < 0.05). Our data suggested that PX/SA should be effective on reducing peritoneal adhesion formation in dogs compared with SCMC. PX/SA may be applicable to preventing post-operative intraperitoneal adhesion in dogs.

이 실험의 목적은 개에서 poloxamer/sodium alginate 혼합물(PX/SA)의 수술 후 복강 유착 방지 효과를 알아보는 것이다. 잡종견 15마리를 무처치군, 2% Sodium carboxymethylcellulose(SCMC)처치군, PX/SA 처치군으로 각각 5마리씩 배치하였다. 유착은 돌창자의 창자간막 대측에 1 ${\times}$ 1 cm 크기로 미세 점상 출혈 찰과상을 일으켜 유도하였다. SCMC 용액은 카테터를 통하여 복강내 주입하였고, PX/SA는 찰과상 부위에 단순히 도포하였다. 수술 전 1일과 수술 후 1일, 4일, 7일, 14일에 정맥에서 혈액을 채취하여 적혈구수, 총백혈구수, 섬유소원농도를 분석하고, 수술 후 21일에 유착정도를 computerized tensiometer를 이용하여 분석하였다. 적혈구수, 총백혈구수, 섬유소원농도는 각 군간에 유의성은 없다. 유착부 분리에 필요한 평균 장력은 무처치군에서 173.05 ${\pm}$ 113.48 gf, SCMC 처치군에서 111.42 ${\pm}$ 38.25 gf, PX/SA 처치군에서 69.00 ${\pm}$ 45.07 gf였다. PX/SA 처치군의 평균 분리 장력이 다른 두 군에 비하여 유의성 있게 낮았다 (p < 0.05). 본 실험 결과로 PX/SA는 SCMC용액과 비교하여 복강유착을 감소시키는 것으로 보아 PX/SA를 개에서 복강 수술 후 유착 방지에 적용 가능한 것으로 생각한다.