Ulus Travma Acil Cerrahi Derg. 2021; 27(3): 284-289 | DOI: 10.14744/tjtes.2020.23460

Boric acid is as effective as hyaluronic acid-based agent in preventing intra-abdominal adhesions in a rat model

Murat Urkan, Hikmet Erhan Güven
Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey

BACKGROUND: In this experimental rat model, we aimed to investigate boric acid’s possible protective effect against the formation of post-operative abdominal adhesions through its anti-inflammatory and antioxidant properties.
METHODS: Forty healthy male albino rats were randomly and evenly allocated to vehicle, hyaluronic acid-based (HA-b) material, boric acid 50 (BA50), boric acid 100 (BA100), and sham groups. Intra-abdominal adhesions were induced by mechanical cecal abrasion. Macroscopic and pathologic assessments of the adhesions were done and tissue tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) levels were measured.
RESULTS: Total abdominal adhesion scores were 129.7, 91.07, 53.77, 90.07, and 140.5 for the vehicle, HA-b, BA50, BA100, and sham groups, respectively, with the highest score indicating more severe adhesions. A significant difference in fibrosis scores was noted between both BA50 and BA100, and the sham group (p=0.018). When objective parameters were analyzed, TNF-α levels were significantly lower in the BA50 group than the sham, BA100, and vehicle groups (p=0.01, 0.019, and 0.03, respectively). TGF-β1 levels were also significantly lower in BA50 group than the sham, BA100, and the vehicle groups (p=0.013, 0.016, and 0.05, respectively). No difference was observed for any parameter between BA50 group and HA-b group.
CONCLUSION: Topical boric acid at a dose of 50 mg/kg is found safe and as effective as the hyaluronic acid-based agent in preventing postoperative abdominal adhesions in our rat model.

Keywords: Boric acid, inflammation; intra-abdominal adhesion; peritoneal.

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Borik asit sýçan modelinde oluþturulan karýn içi adezyonlarýn önlenmesinde hiyaluronik asit bazlý ürün kadar etkili

Murat Urkan, Hikmet Erhan Güven
Saðlýk Bilimleri Üniveristesi Gülhane Eðitim ve Araþtýma Hastanesi, Genel Cerrahi Kliniði, Ankara

AMAÇ: Bu deneysel sýçan modelinde, borik asidin anti-enflamatuvar ve antioksidan özellikleri ile ameliyat sonrasý abdominal adezyon oluþumuna karþý olasý koruyucu etkisini araþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Kýrk adet saðlýklý erkek albino sýçan rastgele ve eþit olarak taþýyýcý, hiyaluronik asit bazlý (HA-b) materyal, borik asit 50 (BA50), borik asit 100 (BA100) ve kontrol gruplarý olarak ayrýldý. Karýn içi adezyonlar mekanik çekal abrazyon ile indüklendi. Adezyonlarýn makroskopik ve patolojik deðerlendirmesi yapýldý ve doku tümör nekroz faktörü-α (TNF-α) ve transforme edici büyüme faktörü-1 (TGF-β1) seviyeleri ölçüldü.
BULGULAR: Toplam abdominal adezyon skorlarý araç, HA-b, BA50, BA100 ve kontrol gruplarý için sýrasýyla 129.7, 91.07, 53.77, 90.07 ve 140.5 idi ve en yüksek skor daha ciddi adezyonlara iþaret ediyordu. Hem BA50 hem de BA100 ile kontrol grubu arasýnda fibrozis skorlarýnda anlamlý bir fark olduðu görüldü (p=0.018). Objektif parametreler incelendiðinde, TNF-α seviyeleri BA50 grubunda kontrol, BA100 ve araç gruplarýndan anlamlý olarak düþüktü (sýrasýyla, p=0.01, 0.019 ve 0.03). TGF-β1 düzeyleri BA50 grubunda kontrol, BA100 ve araç gruplarýndan anlamlý olarak düþüktü (sýrasýyla p=0.013, 0.016 ve 0.05). BA50 grubu ve HA-b grubu arasýnda herhangi bir parametre için fark gözlenmedi.
TARTIÞMA: Sonuç olarak, sýçan modelimizde ameliyat sonrasý abdominal adezyonlarýný önlemede 50 mg/kg dozunda topikal borik asit güvenli ve hiyaluronik asit bazlý ajan kadar etkili bulunmuþtur.

Anahtar Kelimeler: Borik asit, enflamasyon; karýn içi adezyon; peritoneal.

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