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Does Hyaluronic Acid-Carboxymethylcellulose (HA-CMC) Membrane Interfere With the Healing of Intestinal Suture Lines and Abdominal Incisions?

Murat Kalayci, MD

Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University Istanbul Turkey

Umut Barbaros, MD

Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery, Capa, Istanbul, Turkey umutbarbaros{at}yahoo.com

Emre Balik, MD

Türker Bulut, MD

Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University Istanbul Turkey

Although hyaluronic acid-carboxymethylcellulose (HA-CMC) membrane has the advantage of preventing intraabdominal adhesions, it has theoretical risk of negative effects on the healing of intestinal suture lines by forming a barrier between the suture lines and neighboring serosal surfaces. This study evaluated the effect of HA-CMC on bowel anastomoses, scar healing, and intraabdominal adhesion formation. Two groups of 10 male Sprague-Dawley rats were examined. In the first group, laparotomy was performed with a median incision. Colotomy on the cecum and a single-layer repair of the bowel wall was performed. HA-CMC membrane was placed on the cecal suture line and under the laparotomy incision before abdominal closure. The second group had the same procedure but no HACMC membrane was placed. The animals were killed on postoperative day 14. Intraabdominal adhesions, laparotomy suture line endurance, bursting pressure of the repaired cecal wall, and tissue hydroxyproline levels were determined. The repaired cecal wall was also examined histopathologically. The statistical analyses revealed that HA-CMC prevented intraabdominal adhesions significantly. No negative effects of this material on the healing of the bowel and laparotomy suture lines were observed. HA-CMC appears to be a safe material to prevent intraabdominal adhesions, without negative effects on the healing of abdominal incisions and bowel suture lines.

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