Development of a novel glucose polymer solution (icodextrin) for adhesion prevention: Pre-clinical studies

Shelagh J.S. Verco, Elizabeth M. Peers, Colin B. Brown, Kathleen E. Rodgers, Norma Roda, Gere DiZerega

Research output: Contribution to journalArticlepeer-review

106 Scopus citations

Abstract

Intra-abdominal adhesion formation causes significant post-operative morbidity. Controlled studies using animal models have been carried out to assess the tolerability and preventive efficacy of icodextrin solution (a biodegradable, biocompatible, glucose polymer). Reduction of adhesion formation was first evaluated in a rabbit double uterine horn model, applying 10-75 ml of 7.5 and 20%, or 50 ml of 2.5-20% icodextrin solution post-operatively. Significant increases in adhesion free sites (P < 0.005) were observed with volumes ≥25 ml, and at concentrations ≥4%. Efficacy of 50 ml 4 and 20% icodextrin was then evaluated both during and after surgery, demonstrating significant reductions in adhesion formation (P < 0.002). In one study, intraplus post-operative use of 4% icodextrin produced the greatest reduction of non-surgical site adhesions; in others, the post-operative effect was predominant. Post-surgical administration of 50 ml 4% icodextrin in a rabbit sidewall model also resulted in more adhesion-free animals, and a significant reduction (P < 0.001) in areas of adhesion formation and reformation. In a rat infection potentiation model, 4% icodextrin produced no difference in mortality, abscess formation or overall abscess score. These data suggest that 4% icodextrin offers a well-tolerated and effective means of reducing post-surgical adhesion formation.

Original languageEnglish (US)
Pages (from-to)1764-1772
Number of pages9
JournalHuman Reproduction
Volume15
Issue number8
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Glucose polymer
  • Icodextrin
  • Peritoneal adhesions
  • Preclinical

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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