Gómez GGV* and Betancourt ET
Department of Experimental Surgery, Mexican Medicine School of La Salle University, MexicoFulltext PDF
Postoperative abdominal adhesions constitute a condition that occurs in more than 90% of patients undergoing abdominal surgery, and cause major morbidity as intestinal obstruction, secondary infertility and chronic abdominal pain. The purpose of this study was to assess the usefulness of enoxaparin as inhibitor of the coagulation cascade and diclofenac as a non-steroidal anti-inflammatory drug to reduce inflammation, and thus the formation of abdominal adhesions. We used 90 Sprague Dawley rats divided into nine treatment groups of 10 animals each. Surgical adhesions were induced using a controlled brushing of the caecum with sterile cotton gauze and followed by a 3 mm long incision in ileum, repairing with suture. According with the experimental group, Enoxaparine and diclofenac were applied locally or systemic alone or in combination, while all experimental groups were compared against a suitable control group through a midline incision and terminal euthanasia. By far, the greater degree of formation of abdominal adhesions occurs in the non-treated control group I (p<0.05). In contrast, groups III (enoxaparin SC), IV (diclofenac IP) and VIII (diclofenac IP and enoxaparin SC) induced a lower degree of postoperative abdominal adhesions (p<0.01), and the combination of enoxaparin SC and diclofenac (IP) showed be better that when administered individually (p<0.05). Results demonstrated that the combined subcutaneous enoxaparin and intraperitoneal diclofenac reduced the formation of postoperative abdominal adhesions significantly.
Gómez GGV, Betancourt ET. Utility of the Enoxaparin and Diclofenac in Prevention of Postoperative Abdominal Adhesions. Experimental Study in Murine Model. Clin Surg. 2018; 3: 1890.