Effects of Dexamethasone, Piroxicam and Sterile Aloe Vera Extract on the Prevention of Postoperative Peritoneal Adhesion Formation in Rat

Adhesions are a common and unfortunate consequence of most abdominal surgical operations. Some patients form extensive permanent adhesions that can cause abdominal or pelvic pain, infertility and bowel obstruction. Epidemiological studies have highlighted the extent of this problem and the cost to the Health Service, and although there are numerous approaches to prevent adhesion formation by careful laparoscopic, microsurgical techniques, the use of various adhesion barriers and topical pharmacological agents, no method so far has proved completely efficacious in randomized controlled trials. The most effective product for prevention of postoperative adhesion is yet to be discovered. In this study, we decided to evaluate the effects of peritoneal exposure to dexamethasone, piroxicam and sterile aloe vera extract in post-surgical adhesions in rats. Forty adult male wistar rats were divided randomly into four experimental groups; Group 1: Induction of adhesions (IA) + intraperitoneal administration of normal saline, Group 2: IA + intraperitoneal administration of dexamethasone, Group 3: IA + intraperitoneal administration of piroxicam, Group 4: IA + intraperitoneal administration of sterile aloe vera extract. Under general anesthesia the abdominal midline prepared for surgery. A 4cm midline incision was made and the abdomen was opened. Adhesions were induced by removed a 1.5cm × 1.5cm area of transverses abdominus muscle on the right lateral abdominal wall. All rats were euthanized on the 14th day. Adhesions between omentum and abdominal wall were scored in a blinded manner by 2 surgeons according to the method of Evans model. The frequency and intensity of adhesions were recorded, and the mean of the two observers' scores was used for statistical analysis. Results were expressed as mean ± standard deviation. Differences between groups were evaluated by Kruskal–Wallis variance analysis followed by a post hoc Mann– Whitney U-test. P-values <0.05 were considered statistically significant. Most animals developed adhesions between the omentum and abdominal wall and adhesion grades were no statistical significant difference between the treatment groups. However, adhesion grades were significantly different between the treatment groups with control group. In conclusion, the data presented here show that intraperitoneal dexamethasone, piroxicam and sterile aloe vera extract treatment were effective in the prevention of peritoneal adhesions.