Separate and synergistic effects of taurolidine and icodextrin in intra-abdominal adhesion prevention

BACKGROUND: In our present study, we aimed to evaluate the effects of taurolidine, a blocking agent of fibrin deposition, and icodextrin, a colloid osmotic material that also inhibits fibrin accumulation, and the effect of their application separately and concomittantly in intra-abdominal adhesion prevention.
METHODS: Forty BALB/c male mice, weighing 30–35 g and 11–12 weeks old were divided into four groups as follows: group 1: control group, group 2: taurolidine group, group 3: icodextrin group, and group 4: taurolidine and icodextrin group. Animals were sacrificed by cervical dislocation after 14 days. The adhesions were classified and scored by two blinded researchers according to Nair’s macroscopic adhesion staging system and microscopically evaluated using Zuhlke classification system.
RESULTS: In group 2 there was no mice with score 4. In group 3, scores 3 and 4 were absent. Scores 2, 3, and 4 were not detected in group 4. The mean value of adhesion scores decreased from groups 1 to 4. There was a significant statistical difference between all the groups and group 1. There was no change between the study groups on macroscopic examination, whereas histopathological examination revealed statistically significance between group 4 and other groups.
CONCLUSION: Taurolidine and icodextrin, when used alone or together, decrease postoperative intra-abdominal adhesion formation. Macroscopic appearence was not supportive of statistical difference between group 4 and other groups. Microscopic evaluation paves the road for future studies for determining significance when taurolidine and icodextrin are applied concomittantly. Additional experimental studies are required for dose adjustment.

Taurolidin ve icodextrin’in karýniçi yapýþýklýklarýn önlenmesinde ayrý ve sinerjik etkileri

AMAÇ: Çalýþmamýzda fibrin oluþumunu engelleyen ajan olan taurolidin ve fibrin kümelenmesini engelleyen icodextrin’in ayrý ayrý ve birlikte uygulanmasýnýn karýniçi yapýþýklýðýn önlenmesine olan etkisini deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Kýrk adet 30–35 gram aðýrlýðýnda, 11–12 haftalýk erkek BALB/c fare, 4 gruba ayýrýldý. Grup 1: Kontrol grubu, Grup 2: Taurolidin grubu, Grup 3: Ýsodekstrin grubu ve Grup 4: Taurolidin ve isodekstrin grubu olarak adlandýrýldý. Deney hayvanlarý 14. gün servikal dislokasyonla sakrifiye edildiler. Yapýþýklýklar iki kör araþtýrmacý tarafýndan Nair’in makroskobik yapýþýklýk skorlama sistemiyle sýnýflandýrýldý. Mikroskobik deðerlendirme için Zühlke’nin sýnýflandýrmasý kullanýldý.
BULGULAR: Grup 2’de skor 4 olan fare olmadý. Grup 3’te skor 3 ve 4 olan fare yoktu. Skor 2, 3 ve 4 Grup 4’teki farelerde saptanmadý. Grup 1’den 4’e doðru yapýþýklýk skor ortalamalarýnýn azaldýðý görüldü. Kontrol grubuyla tüm çalýþma gruplarý arasýnda istatistiksel açýdan anlamlý farklýlýk saptandý. Makroskobik deðerlendirmede çalýþma gruplarý arasýnda farklýlýk saptanmazken histopatolojik incelemede Grup 4 ve diðer çalýþma gruplarý arasýnda istatistiksel açýdan anlamlý farklýlýk saptandý.
TARTIÞMA: Taurolidin ve isodekstrin ayrý ayrý veya beraber kullanýldýðýnda karýniçi yapýþýklýk oluþumunu azaltmaktadýr. Makroskobik görünüm taurolidin ve isodekstrin grubuyla diðerlerinin istatistiksel açýdan farklýlýðýný desteklememektedir ancak mikroskobik deðerlendirme beraber kullanýldýklarýnda farklýlýk yaratmasý nedeniyle gelecek çalýþmalara yol göstermektedir. Doz ayarlamasý için ilave deneysel çalýþmalar gereklidir.