• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.161-167
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• 1997

This study was carried out to prevent the abdominal re-adhesions in dogs. Two randomized groups of dogs were subjected to scratch the ileal serosa. Routine abdominal closure was performed on two groups. Second laparotomy was performed one month later for the scoring of the abhesion formation. The adhesions were separated physically after the scoring of the adhesions. In control goup saline was instilled into abdomen and in treated group 1% sodium carboxymethylcellulose(SCMC) solution was instilled into abdomen before the abdominal closure. Third laparotomy was performed another month later to evaulate the adhesions. Reduced adhesion formation following the instillation of 1% SCMC was reported. 1% SCMC is recommended to prevent the re-adhesions as well as adhesions.

• Development and Reproduction
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• v.15 no.4
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• pp.291-299
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• 2011

The membranous adhesions could induce implantation failure despite transplantation of high quality of embryo. Clinically, of the patients who have membranous filmy adhesions, endometrial polyps have been found in not infrequently. Thus this study was tried to evaluate the features of endometrial polyps and the effect of endometrial polyps on formation and extents of membranous adhesions in uterine cavity of infertile patients under hysteroscopy. A retrospective study was conducted on 34 infertile patients who were diagnosed as endometrial polyps with membranous adhesions during hysteroscopy from July 2008 to July 2011. Number, size, location and morophologic type of endometrial polyps were investigated. If needed, methylene blue solution was instillated to endometrial cavity to identify membranous adhesions. Then, associations between membranous adhesions with features of endometrial polyps were evaluated. Mean size of endometrial polyp was $1.6{\pm}0.6$ cm, the bigger of endometrial polyps was, the larger of extents of membranous adhesions. (p<0.05). Endometrial polyps were locate evenly in endometrial cavity as follows: anterior uterine wall, 39.1%; posterior uterine wall, 34.8%; lateral uterine wall, 26.1%; upper: 29.4%, middle: 32.4%, lower segment, 35.3%. Mean number of endometrial polyps was $2.26{\pm}1.3$. The pedunculated type was 37.7% and sessile type was 32.4%. There was no statistically significant association of location, number and morphologic type of endometrial polyps with membranous adhesions. In conclusion, hysteroscopy before in vitro fertilization on infertile patients was worthy because of removing of endometrial polyps and membranous adhesions.

• Journal of Veterinary Clinics
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• v.10 no.1
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• pp.19-35
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• 1993

These studies performed to establish the diagnostic methods for the luminal adhesions to abdominal wall with radiography, ultrasonography and electromyography, and to evalute sodium carboxymethylcellulose(SCMC) for prevention of the abdominal adhesions in goats. The adhesion sites were not detected by rediography and ultrasonography at non-pneumoperitoneum, but detected after pneumoperitoneum in goats with experimentally induced ruminal abhesions to abdominal wall. Electromyography revealed only the presence of intraabdominal adhesions. In fibriongen values and total leucocytes, there were no alterations between SCMC treated and non-treated group. The average gross scores of adhesions in SCMC treated and non-treated were 0.3 and 2.7, respectively. It was concluded that radigraphy, electromyography and ultrasonography could be available for the diagnosis of the ruminal adhesions to abdominal wall and the use of SCMC was useful to prevent the intraabdominal adhesions in ruminants.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.225-231
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• 1986

Pericardial adhesions following open heart surgery pose a special problems, increasing the risk of cardiac reoperation because of the danger of damaging the heart, coronary artery and veins, or grafts and also the fibrous tissue may obliterate the pericardial space and eventually constrict the heart. This study was undertaken to evaluate the effect of intrapericardial urokinase and dextran 40 on the formation of pericardial adhesions in an animal model. latrogenic traumas on the pericardium were surgically induced in 30 rabbits, simulating injuries possible during actual surgery. In all rabbits, blood [1 ml] was obtained from an ear vessel and injected into the pericardium. Control group of ten rabbits did not receive any further medication, urokinase group of ten received 15, 000-20, 000 IU of urokinase, and remained ten received 1 ml of 10% dextran 40. All rabbits were sacrificed at 4 weeks. At autopsy, the development of adhesions were graded as none [Grade I], minimal [Grade II], moderate [Grade III], and severe [Grade IV]. Histological studies of the parietal pericardium and epicardium were performed. The results were as follows: 1. Group 1[Control group] showed minimal adhesion in 40%, moderate in 50%, and severe in 10% of the group. Sharp dissections were necessary in 60% of adhesions. 2. Group II [Dextran group] showed no adhesions in 20%, minimal in 60%, and moderate in 20% of the group. 3. Group III [Urokinase group] showed no adhesions in 40%, minimal in 40%, and moderate in 20% of the group. Considering in this group, the adhesion activity was significantly suppressed [60% adhesions] compared to the control group [100% adhesions] [P < 0.05]. 4. Histological findings revealed mild serosal fibrosis in none adherent group, loose fibrous connections between two layers of pericardium in minimal adhesion group, tight fibrous connections in moderate adhesion group, and marked fibrous thickening and close attachment of two surfaces were noted in severe adhesion group. These data have revealed the decreased incidence of pericardial adhesions with urokinase and dextran 40.

• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.494-500
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• 2008

The aim of this study was to determine the effectiveness of hyaluronic acid-carboxymethylcellulose membrane (GUARDIX-$MB^{(R)}$) barriers on prevention against post-operative peritoneal adhesions. In this study, fourteen mongrel dogs were divided into two experimental groups: 0.1 % hyaluronic acid (0.1HA) group and hyaluronic acidcarboxymethylcellulose membrane (HA-CMC) 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 homogenous petechial hemorrhagic surface over a $1\;{\times}\;1cm$ area. Solution of 0.1HA were simply coated over the abraded tissues, $1.5\;{\times}\;1.5cm$ HA-CMC membrane was placed over the abraded tissues, allowed to spread across the intra-abdominal organs before closure of the abdomen. On day 1 before and day 1, 4, 7, 14, and 21 after operation, venous blood specimens were collected for measurement of fibrinogen and total WBC. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The fibrinogen and total WBC values of two groups showed no statistical significances. The mean tensile strength (gram force, gf) of formed adhesions day 21 after surgery was $88.1\;{\pm}\;55.70gf$ in the 0.1 % HA group and $24.8\;{\pm}\;22.69gf$ in the HA-CMC group. The tensile strength values of adhesion separation HA-CMC membrane group was significantly lower than the 0.1HA group (p<0.05). Therefore, we suggest that HACMC membrane reduce peritoneal adhesions may be applicable to preventing post-operative intraperitoneal adhesions in dogs.

• Korean Journal of Veterinary Research
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• v.45 no.3
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• pp.417-421
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• 2005

Adhesions are the most common postoperative complication in intestinal surgery in dogs. This study was aimed at verify to the efficacy of sodium carboxymethylcellulose (SCMC) in the adhesion prevention during healing of intestinal anastomosis. Twenty three healthy dogs were taken with average 4.17 years and weight was 5.68 kg and divided into 4 groups. The dogs of group III and IV, a pedicle of greater omentum was wrapped around the suture line. In the animals of group II and IV, 1% SCMC was infused (5 ml/kg, IP) at just before closure of the abdominal cavity. Two weeks after surgery, animals were reoperated and the adhesions were evaluated and graded. We found various degrees of intraabdominal adhesions in animals of all the groups. The significantly (P<0.05) lower adhesion score was observed in group IV than that of other groups. Nevertheless, varying intra-peritoneal adhesions, healing of anastomotic site was normal in all groups. It could be concluded that intra-peritoneal administration of SCMC solution reduces postoperative adhesions without any adverse effects on healing, and a synergistic beneficial effect can be obtained by supplementation with omental graft for intestinal anastomosis.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.451-457
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• 1987

Reoperations following cardiac surgery have an increased risk of the danger of damaging the heart, great vessels or extracardiac grafts because of adhesions to the sternum. We experimentally evaluated 3 different methods for pericardial closure. A standardized procedure for induction of pericardial adhesions was carried out in 30 rabbits. For closure of pericardium, animals were divided into 3 groups, 10 animals respectively: Croup 1 [simple pericardial closure]The pericardium was primarily resuture; Group 2 [Core-Tex surgical membrane as a pericardial substitute]- A Gore-Tex surgical membrane was interposed between the sternum and the heart; and Group 3 [pericardial tension releasing technique]-Three longitudinal overlapping incisions were made on the right side of the pericardium while the midline incison was sutured. Animals were put to death 4 weeks postoperatively and the pericardial space was examined for pericardial adhesions and epicardial reactions. The extent of adhesions and reactions were graded as: I-none; II-minimal; III-moderate; and IV-severe. Histologic studies of the pericardium, the pericardial substitute and the epicardium were also performed. The results were as follows: 1. In group 1 [simple pericardial closure], the degree of pericardial adhesions were grade I in 1 animal, grade II in 2, grade III in 4 and grade IV in 3. Epicardial reactions were grade I in 1 animal, grade II in 3, grade III in 5 and grade IV in 1. Histologic examination revealed thick fibrous tissue that obliterated the pericardial space in 7 animals. 2. In group 2 [Gore-Tex surgical membrane as a pericardial substitute], the degree of pericardial adhesions were grade I in 3 animals, grade II in 3, grade III in 2 and grade IV in 2. The degree of epicardial reactions were grade II in 1 animal, grade III in 5 and grade IV in 4. Histologic studies revealed a thin layer of dense fibrous tissue which covered the Gore-Tex surgical membrane and thick loose fibrous tissue on the epicardium just beneath the substitute. 3. In group 3 [pericardial tension releasing technique], the degree of pericardial adhesions were grade I in 3 animals, grade II in 4, grade III in 2 and grade IV in 1. The degree of epicardial reactions were grade 1 in 4 animals, grade II in 4 and grade III in 2. Severe epicardial reactions were not observed in this group. Histologic examination showed normal epicardium in 4 animals and the epicardium of the other 6 animals only revealed very thin fibrous layer compared to group I and group II. Pericardial adhesions more than grade III were 70% in group 1, 40% in group 2 and 30% in group 3. Pericardial adhesions were reduced in group 2 and group 3 compared to group 1, but statistically not significant. Epicardial reactions more than grade III were 60% in group 1, 90% in group 2 and 20% in group 3. Epicardial reactions were significantly reduced in group 3 compared to group 2. Author`s modified pericardial releasing technique provides marked augment of pericardial surface area and facilitates tension-free pericardial closure. Furthermore, pericardial adhesion and epicardial reaction will be reduced with the pericardial tension releasing technique.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.381-387
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• 2000

Efficacy of a 1% solution of sodium carboxymethylcellulose (SCMC) infu7ed into the peritoneal cavity of dogs was evaluated for prevention of intraperitoneal adhesion, resulting from operations of the reproductive tract. Saline-treated deles (n = 5) were controls that underwent ventral midline celiotomy, and adhesions were cleated by incision and scraping about 5 cm segment of each uterine horn. Saline (7 ml/kg of body weight) was then infused into the peritoneal cavity. Others (n = 5) were treaded similarly to the saline-treated dogs. except that 1% SCMC :solution (7mH/kg of body weight) was infused into the peritoneal cavity. This group was studied to determine whether SCHC would prevent the adhesions in the peritoneal cavity, especially in the uterine horn model. Abdominal adhesions were evaluated and an adhesion severity score was assigned to each dog on the basis of severity of adhesions. At the time of necropsy. the mean adhesion score in the saline treated group was $2.65{\pm}0.22.$ In contrast, adhesion formation in the SCMC treated group was less ($mean score =1.70{\pm}0.26$). Statistic71 analysis was performed using the grouped t-test and paired t-test. A significanlty lower adhesion score was observed in dogs given SCMC than in the saline treated group (P<0.01). In summary, SCMC significantly reduced adhesion formation in the dog uterine horn model. The results of this study suggest that application of 1% SCMC solution, following various reproductive pelvic surgery, will present the adhesions.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.12-17
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• 1986

The pericardial adhesions following the first open heart surgery pose a major problem that can increase the morbidity and mortality in cases of reoperation because of the danger of damaging the heart, great vessels or grafts. The purpose of this study was to determine the effect of intrapericardial infusion of 5% dextrose solution and heparin on experimental pericardial adhesions. The 15 white rabbits were divided into three treatment groups of 5 animals each: group 1 [control group], group 2[5% dextrose group] and group 3 [heparin group]. At 4 weeks, all animals were sacrificed and the pericardial adhesions were graded as follows: 1[none], ll[mild], Ill[moderate] and IV[severe]. Histological examination was performed on a subset of each group. The difference of adhesion between control and heparin group was evaluated by Chi-square analysis. The results were as follows: 1. Pericardial adhesions developed in 80% of animals in group 1 and 2. 2. Only 40%> of animals in group 3 had mild to moderate pericardial adhesions. This was significantly different from the control group [P=0.01]. 3. Histological examination showed that the pericardium with adhesion was thickened with fibrosis, while that without adhesion was thin, normal appearance. 4. In group 3, there was no evidence of hemorrhage or hemorrhagic tendency in the pericardium.

• Journal of Medicine and Life Science
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• v.21 no.3
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• pp.102-105
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• 2024

Omental adhesions to the anterior abdominal wall are a common complication of abdominal surgery. Specific adhesions to the back of the umbilicus represent a challenge for safe laparoscopic access. In this case report, we describe a simplified two-port laparoscopic access procedure for retro-umbilical adhesiolysis. We concluded that successful adhesiolysis of retro-umbilical adhesions using the sequential Darwish and Lee-Haung points is feasible, and this procedure is a safe, minimally invasive alternative to the primary laparoscopic approach.