Postoperative adhesion prevention using a statin-containing cellulose film in an experimental model

Br J Surg. 2012 Mar;99(3):423-9. doi: 10.1002/bjs.7817. Epub 2012 Jan 13.

Abstract

Background: Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm(®)) in the prevention of postoperative intraperitoneal adhesions in rats.

Methods: One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm(®) group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation.

Results: All antiadhesive film groups (Seprafilm(®), placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm(®) in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm(®) group, but only one-quarter in the low-dose Statofilm group.

Conclusion: The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm(®) in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application.

MeSH terms

  • Animals
  • Atorvastatin
  • Biocompatible Materials / administration & dosage
  • Carboxymethylcellulose Sodium / administration & dosage*
  • Fibrosis
  • Heptanoic Acids / administration & dosage*
  • Hyaluronic Acid / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Male
  • Pyrroles / administration & dosage*
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Tissue Adhesions / pathology
  • Tissue Adhesions / prevention & control*

Substances

  • Biocompatible Materials
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrroles
  • Seprafilm
  • Hyaluronic Acid
  • Atorvastatin
  • Carboxymethylcellulose Sodium