Ahmed Almamar, MD, MSc, FRCSC, Nawar Alkhamesi, MD, PhD, FRCS, FRCSED, FRCSC, Christopher M Schlachta, BSc, MDCM, FRCSC, FACS. Western University and Canadian Surgical Technologies and Advanced Robotics (CSTAR), London, Canada
Introduction: Adhesions are a cause of morbidity following surgery. Multiple approaches have been evaluated to minimize them. Aerosolized heparin and hyaluronic acid is an effective method to prevent adhesions whether they were used independently or in synergism. However, the absorption rate of aerosolized intraperitoneal heparin alone or mixed with hyaluronic acid and its systemic effect never been evaluated. The aim was to evaluate the systemic effect and the absorption rate of heparin with or without hyaluronic acid in the prevention of abdominal adhesion.
Material and Methods: A randomized-controlled study was conducted comparing thirty rats divided into 3 groups. First group (n=10) received aerosolized intra-peritoneal heparin (IPH). Second group (n=10) received intra-peritoneal heparin mixed with hyaluronic acid (IPHHA). Intravenous heparin (IVH) was given to the third group (n=10) (Positive control). Serum heparin levels for each animal were measured and compared between the groups over at 30, 60, 90, and120 minute’s period.
Results: None of the rats had intra-operative bleeding. Serum heparin in the aerosolized groups (IPH & IPHHA) were significantly lower than the control group (IVH) at all points of measurements with IPHHA showing the lowest absorption compared to IPH & IVH (p<0.0001). The serum level of heparin of all groups peaked at 90 minutes. Area-under-the-curve 0-120 was significantly lower in the IPHHA group as compared to both IPH and IVH (p<0.0001).
Conclusion: The aerosolized intra-peritoneal heparin alone or in combination with hyaluronic acid resulted in minimal systemic absorption rendering it safe for the use as method to prevent adhesions. Human studies are planed.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78777
Program Number: P077
Presentation Session: Poster (Non CME)
Presentation Type: Poster
