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J Laparoendosc Adv Surg Tech A. 2018 Feb;28(2):134-139. doi: 10.1089/lap.2017.0404. Epub 2017 Sep 14.

The Effects of Barrier Agents in Postoperative Pelvic Adhesion Formation: A Comparative Study of a Temperature-Sensitive Poloxamer-Based Solution/Gel and a Hyaluronic Acid-Based Solution in a Rat Uterine Horn Model.

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1 Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine , Seoul, Korea.
2 Department of Anesthesiology, Chung-Ang University College of Medicine , Seoul, Korea.
3 Department of Pathology, Chung-Ang University College of Medicine , Seoul, Korea.



The aim is to evaluate the efficacy of poloxamer/alginate/CaCl2 mixture (PACM) solution/gel and hyaluronic acid/carboxymethylcellulose (HA-CMC) solution for reducing pelvic adhesion in a rat uterine horn model.


A total of 48 females, Sprague Dawley rats, were divided into three groups according to the applied materials. A uterine horn adhesion model was created. The control group (group CO; n = 16) received no special materials except saline infusion. The experimental groups were treated with 1.0 mL HA-CMC solution (group HA-CMC; n = 16) or 1.0 mL PACM solution/gel (group PACM; n = 16). Adhesion scores were evaluated with macroscopic, microscopic, and immunohistochemistry grading 14 days postoperatively.


Macroscopic adhesion scores, including extent, severity, and total scores in group HA-CMC and group PACM, were significantly lower than those in group CO (P < .001). Among these three categories of scoring, group PACM had a significantly lower score than did group HA-CMC in adhesion severity (P = .025). In the microscopic adhesion score analysis, the fibrosis scores in group HA-CMC and group PACM were also significantly lower than that of group CO. In group PACM, the fibrosis score was significantly lower than that of group HA-CMC. There were no statistical differences across all three groups in the microscopic inflammation and immunohistochemistry staining.


Both HA-CMC solution and PACM solution/gel effectively reduced adhesion formation. PACM solution/gel was superior to HA-CMC solution in preventing pelvic adhesion, especially in adhesion severity and microscopic fibrosis.


adhesion prevention; hyaluronic acid; pelvic adhesion; poloxamer

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