Prevention of intestinal adhesions to intraperitoneal meshes with the addition of hyaluronic acid/carboxymethylcellulose gel. Experimental model in rats

Background: Intraperitoneal meshes produce adhesions and intestinal fistula. Composite materials with an antiadherent barrier prevent that complication. There are no studies using gel products in meshes in an attempt to prevent intraperitoneal adhesions Methods: Two groups of 20 rats each were used. Polypropylene mesh was placed intraperitoneally in both groups adding hyaluronic acid/carboxymethylcellulose gel to the mesh in the study group. At 28 days, rats were sacrificed and evaluated using the Diamond adhesions scale. Results: There were 20 rats in the study group and 19 rats in the control group (one postoperative death). All rats in the control group (100%) had adhesions, most of them (74%) more than 26% of the mesh surface, 58% strong and cohesive needing adhesiolysis with scissors in 68%. In the study group, 95% had adhesions, most of them (70%) less than 26% of the mesh surface, usually thin and avascular in 55%, needing just mild to moderate traction for adhesiolysis. Conclusions: Hyaluronic acid/carboxymethylcellulose gel appears to be effective in reducing the percentage of adhesions to segments of intraperitoneal mesh implants.