Reduction of adhesion formation with hyaluronic acid after peritoneal surgery in rabbits

Objective: To examine the effect of hyaluronic acid, a high-molecular- weight glucosaminoglycan found in the extracellular matrix, on the formation of adhesions, a major source of postoperative complications. Design: The ability of hyaluronic acid to reduce adhesion formation was evaluated using a standardized rabbit model. The material was administered IP at the end of surgery. Setting: University laboratory. Animal(s): New Zealand White female rabbits. Intervention(s): Intraperitoneal administration of various formulations of hyaluronic acid at the end of surgery. Main Outcome Measure(s): One week after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. Result(s): Five separate molecular weight ranges of hyaluronic acid representing eight viscosities between 1,000 and 12,000 centipoise (CPS) were shown to reduce adhesion formation in this model. All volumes, 1 to 30 mL, of hyaluronic acid tested reduced adhesion formation. In addition, the low-viscosity, low-molecular- weight hyaluronic acid significantly reduced adhesion formation when added to the trauma site or when injected at a site remote from the trauma area. Conclusion(s): This study showed that hyaluronic acid administered at the end of surgery reduced adhesion formation.