Anti-adhesive effects of Budesonide combined with spraygel in a cecal abrasion model: an experimental study

Ozer M., Onguru O., EKEN A., Sinan H., Coskun K., Akgul E. O., ...More

JOURNAL OF ADHESION SCIENCE AND TECHNOLOGY, vol.26, no.24, pp.2719-2727, 2012 (SCI-Expanded) identifier identifier


Many methods have been described for preventing or reducing postoperative adhesions. In this work, we evaluated the effectiveness of Budesonide in combination with SprayGel in a reducing postoperative adhesion in rats as the model. Cecal abrasion was achieved in 60 male Sprague-Dawley rats, by brushing and by applying 70% alcohol. The rats were separated into six groups and treated with six solutions (Group I - saline; II - Budesonide 50 mu g; III - Budesonide 250 mu g; IV - SprayGel; V and VI - SprayGel + Budesonide 50 and 250 mu g). Serum Budesonide, glucose, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and blood urea nitrogen levels were measured at postoperative day (POD) 2 and 14. The rats were killed on POD 14, and intra-abdominal adhesion formation was scored. Histopathological samples were obtained from the cecum and terminal ileum to evaluate microscopic adhesion formation. Our results showed that Group VI had both the minimum macroscopic adhesion score and the minimum microscopic score. All other groups had significantly lower microscopic adhesion scores than Group I. However, there was no statistical significance among any other groups. Serum AST levels of Group III were significantly higher than in Groups I, II, IV, and V (p < 0.046). Serum AST levels of Group III on POD 14 were also significantly higher than that of all other groups (p < 0.02). On POD 14, there was no Budesonide in the sera of Groups II and V. However, Groups III and VI had trace amounts of Budesonide (0.009 and 0.007 mu g, respectively). In conclusion, we have showed that the effect of Budesonide is dosedependent. Both anti-adhesive and hepatotoxic side effects of Budesonide increased as the dose increased. Combining Budesonide with SprayGel synergistically increased the anti-adhesive benefits and prevented hepatotoxicity from the slower release of Budesonide.