Reduction of postsurgical adhesions in a rat model: a comparative study

background: adhesion formation after peritoneal surgery is a major cause of postoperative bowel obstruction, infertility, and chronic pelvic pain. in this study, we compared the possible individual effects of phosphatidylcholine (pc), seprafilm？ ii, and tissue plasminogen activator (t-pa) and the combined effects of phosphatidylcholine and t-pa on postoperative adhesion formation in a rat surgical model. materials and methods: a total of 50 wistar male rats underwent median laparotomy and standardized abrasion of the visceral and parietal peritoneum. phosphatidylcholine, seprafilm ii, and t-pa alone and phosphatidylcholine and t-pa in combination were applied intraperitoneally at the end of the surgical procedure. seven days after surgery, a relaparotomy was performed for adhesion grading and histopathological examination. results: a comparison of adhesion stages demonstrated a significant difference between the control group and the study groups (p<0.001). the adhesion grade of the combined treatment group was statistically different from that of the other groups (p<0.05). in the t-pa group and the combined group, six and two rats, respectively, developed hematomas locally on the cecum. conclusions: pc, t-pa, and seprafilm ii used individually reduced the adhesion grade. the t-pa and phosphatidylcholine combination was most effective in reducing adhesion formation. on the other hand, usage of t-pa alone or in combination may increase risk of bleeding. more detailed studies are needed, and future studies on the efficacy of a material for decreasing adhesion formation should include a comparison of several control materials in the same model.