One percent sodium carboxymethylcellulose prevents experimentally induced abdominal adhesions in horses

OBJECTIVE--To evaluate the efficacy of 1% sodium carboxymethylcellulose (SCMC) for prevention of experimentally induced abdominal adhesions in horses. STUDY DESIGN--Prospective, controlled, experimental study. ANIMAL POPULATION--Twelve healthy adult horses. METHODS--The effect of 1% SCMC on adhesion formation was evaluated in 12 healthy horses by using an established model of serosal trauma to induce intraabdominal adhesions. After ventral median celiotomy, 2 separate areas of the jejunum were abraded, and three 2-0 chromic gut sutures were placed in each abraded area. Jejunal resection and end-to-end anastomosis was performed at 2 sites distant to the abrasion sites. In treated horses (n = 6), 2 L of 1% SCMC was applied to the intestine before and after intestinal manipulation. In control horses (n = 6), 2 L of saline solution were applied to the intestine before and after surgical manipulation. All horses were euthanatized 10 days after surgery, and the abdominal cavity was evaluated for adhesion formation. The frequency of intraabdominal adhesions between groups was compared with a chi-square test. Statistical significance was set at P <.05. RESULTS--All control horses had intraabdominal adhesions. Fibrous adhesions were associated with both jejunal abrasion sites in 5 control horses. Fibrous adhesions were also associated with 1 or both jejunal anastomotic sites in 5 control horses. Only 1 treated horse developed adhesions at the jejunal abrasion sites, and no adhesions were present at the anastomotic sites in the treated horses. There were significantly fewer adhesions in the SCMC treatment group compared with the control group (P <.05). CONCLUSION--In this experimental model, application of 1% SCMC reduced the frequency of intraabdominal adhesions at areas of serosal abrasion and at jejunal anastomotic sites. CLINICAL RELEVANCE--In horses at an increased risk for developing intraabdominal adhesions after intestinal surgery, the use of 1% SCMC during celiotomy may decrease the frequency of adhesion formation.