Prevention of retrosternal-epicardial adhesion formation in a rabbit model

Abstract

Retrosternal epicardial adhesions may cause significant injuries to the heart and great vessels in cases that require reoperation. We used a varity of agents to prevent the occurence of adhesions and observed different results. An experiment with 3 groups of rabbits with 10 rabbits in each group was prepared to investigate the roles of Dexamethazone-Ringer Lactate (DM-RL) combination and Hyaluronic Acid-Carboxylmethyl Cellulose (HA-CMC) in preventing adhesions. First group (Group I) was the control group, the second (Group II) was tested for DM-RL and the third group (Group III) was tested for HA-CMC. These agents were topically applied to the epicardial region after the sternotomy and pericardiotomy phases. The adhesion score was significantly higher in the first group than the adhesion score in the second group (p<0.05). The first group had significantly higher chronic inflammatory cell response, adhesion score and adhesion percentage than the third group (p<0.05). In these groups, no differences of fibrosis and acute cell response were observed on statistical terms (p>0.05). The second group had higher acute inflammatory cell response and adhesion percentage than the third group in statistical terms (p<0.05). There was no statistically differences of fibrosis, adhesion score and cronic inflammatory cell response in these groups. We have found that the use of bioresorbable membrane containing DM-RL and HA-CMC clearly decreases the postoperative epicardial and retrosternal adhesions. The use of membrane containing HA-CMC is found to be more effective than the use of membrane containing DM-RL.