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Fig 1.

Per operative images showing the positioning of the various anti-adhesion devices.

A 4x3.5 cm film of polymer A or B was interposed between the defect and the cecum in group PA and PB (delineated with dashed lines) (A). A 4x3.5 cm film of Seprafilm was interposed in the same way (delineated with dashed lines) (B). One milliliter of Hyalobarrier gel was applied on the abraded cecum (arrow heads) (C). No anti-adhesion agent was used in the control group (D).

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Fig 1 Expand

Table 1.

Evaluation of adhesion using Leach score.

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Table 1 Expand

Fig 2.

Flow chart of the protocol.

Rats were randomized in five groups. In vivo degradation was evaluated at day 2, 5 and 12. Efficiency was evaluated at day 5 and Day 12.

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Fig 2 Expand

Fig 3.

Adhesion assessment at day 5 and 12 by macroscopic examination.

Necropsy pictures from different groups showing adhesions between cecum and parietal peritoneum (white arrowheads). At day 5 no adhesion was observed in Hyalobarrier group (A) or polymer A group (C), whereas strong adhesions were seen in control group (B), Seprafilm group (D) and Polymer B (E). At day 12: No adhesions were observed in polymer A group (H) whereas adhesions were apparent in Hyalobarrier group (F), Seprafilm group (I), Polymer B group (J) and control group (G).

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Fig 3 Expand

Table 2.

Results of efficiency study at days 5 and 12.

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Table 2 Expand

Fig 4.

In vivo degradation study.

Necropsy images from polymer A and B group at day 2, 5 and 12. At day 2 polymer A was intact (A), split into fragment at day 5 (white arrow) (B) and was transformed into a gel at day 12 (white arrow). Polymer B was transformed into a gel from day 2 (white arrow) (D) was in an advanced stage of degradation at day 5 (white arrow) (E) and was almost invisible at day 12 (F).

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Fig 4 Expand

Fig 5.

Histopathological examination at day 12.

Photomicrographs from HES stained slides, magnification x5. Adhesions were visible in control group as fibrous tissue rich in fibrin, collagen and fibroblast appending the caecum and peritoneum (delineated with dashed lines) (A). Remesothalization is evident in group PA (B), Hyalobarrier (C) and Seprafilm (D) (arrows depict peritoneal defects).

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