Effect of Honey versus Icodextrin on Adhesion Reformation after Adhesiolysis: an Experimental Study in Rats
Journal of Surgery
Volume 4, Issue 1-1, January 2016, Pages: 5-10
Received: Aug. 6, 2015;
Accepted: Aug. 7, 2015;
Published: Sep. 8, 2015
Views 4013 Downloads 697
Aly Saber, Port-Fouad General Hospital, Port-Fouad, Egypt
Mohammed H. Shekidef, Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Ismailia, Suez Canal University
Aya Aly Saber, Port-Fouad General Hospital, Port-Fouad, Egypt
Introduction: Although the process of de novo adhesion formation after operation has been fairly well established, adhesion reformation in a previously affected zone is still poorly understood. Honey was proved effective as an anti-adhesive agent in experimental animals. The aim of the present experimental study is to investigate the effect of HONEY on adhesion reformation prevention when compared with ICODEXTRIN in rats. Materials & Methods: 75 healthy male Sprague–Dawley rats having average weight250–300 g were divided into three groups for study: [25 rats for each], Honey, Icodextrin and control groups. Laparotomy was done carefully for not to disturb any adhesion could be attached to the previous laparotomy incision. Any adhesion band was dissected and divided gently and smoothly with sharp maneuver using fine surgical scissors. In case of groups A and B, three ml of Honey and Icodextrin were instillated, using sterile syringes; into the abdominal cavity before completing laparotomy wound closure to prevent escape of the material outside the peritoneal cavity. Results: Total adhesion score among the three groups showed statistically significant difference using the ANOVA test but when comparing group A and B,the difference is considered to be not statistically significant. Conclusion: Both icodextrin and honey has beneficial effect on reduction of the extent and severity of intraperitoneal adhesion reformation in our rat model for colonic anastomoses. Honey surpasses icodextrin regarding the total adhesion score and the score per animal.
Mohammed H. Shekidef,
Aya Aly Saber,
Effect of Honey versus Icodextrin on Adhesion Reformation after Adhesiolysis: an Experimental Study in Rats, Journal of Surgery. Special Issue:Abdominal Surgery: Toward the Best.
Vol. 4, No. 1-1,
2016, pp. 5-10.
Aly Saber. Effect of honey versus intergel in intraperitoneal adhesion prevention and colonic anastomotic healing: A randomized controlled study in rats. I J S, 8 (2010) 121–127
Roman H, Canis M, Kamble M, et al. Efficacy of three adhesion-preventing agents in reducing severe peritoneal trauma induced by bipolar coagulation in a laparoscopic rat model. FertilSteril. (2005).83 Suppl 1:1113-8.
Gómez-Gil V, García-Honduvilla N, Pascual G, Rodríguez M, Buján J, Bellón JM. Peritoneal adhesion formation and reformation tracked by sequential laparoscopy: Optimizing the time point for adhesiolysis. Surgery. 2010 ;147(3):378-91
Muzii L. Survey among Members of the Roman Group of Gynecologic Endoscopy on the Use of Agents for Postoperative Adhesion Prevention. J Am Assoc Gynecol Laparosc.2004 ;11(2):248-51.
Pados G, Makedos A and Tarlatzis B.(2013); Adhesion Prevention Strategies in Laparoscopic Surgery. In: Endoscopy. SomchaiAmornyotin (ed). InTech. Page: 49-72
Sutton, C. Adhesions and their prevention. Obstet. Gynaecol. 2005; 7: 168–176.
Trew G, Pistofidis G, Pados G, Lower A, Mettler L, Wallwiener D, Korell M, Pouly JL, Coccia ME, Audebert A, Nappi C, Schmidt E, McVeigh E, LandiS,Degueldre M, Konincxk P, Rimbach S, Chapron C, Dallay D, Röemer T, McConnachie A, Ford I, Crowe A, Knight A, Dizerega G, Dewilde R.Gynaecological endoscopic evaluation of 4% icodextrin solution: a European, multicentre, double-blind, randomized study of the efficacy and safety in the reduction of de novo adhesions after laparoscopic gynaecological surgery. Hum Reprod.2011 ;26(8):2015-27.
Saber A, Shekidef MH, El-Daharawy MH. Fecal Peritonitis in Rats.J. Adv. Vet. Res. 2011; 1(1): 8-12.
Klink CD1, Schickhaus P, Binnebösel M, Jockenhoevel S, Rosch R, Tolba R, Neumann UP, Klinge U.Influence of 4% icodextrin solution on peritoneal tissue response and adhesion formation. BMC Surg. 2013 Sep 10;13:34. doi: 10.1186/1471-2482-13-34.
Shi Z, Ma L, Yang Y, Wang H, Schreiber A, Li X, et al.: Adhesion formation after previous caesarean section-a meta-analysis and systematic review. BJOG 2011, 118:410-422.
Luciano DE, Roy G, Luciano AA. Adhesion Reformation After Laparoscopic Adhesiolysis: Where, What Type, and in Whom They Are Most Likely to Recur. J Minim Invasive Gynecol.2008 ;15(1):44-8.
Prushik SG, Stucchi AF, Matteotti R, Aarons CB, Reed KL, Gower AC, Becker JM. Open adhesiolysis is more effective in reducing adhesion reformation than laparoscopic adhesiolysis in an experimental model. Br J Surg. 2010 Mar;97(3):420-7.
Wiggins T, Markar SR, Harris A. Laparoscopic adhesiolysis for acute small bowel obstruction: systematic review and pooled analysis. SurgEndosc. 2015 Apr 4. [Epub ahead of print]
Schnuriger B, Barmparas G, Branco BC, Lustenberger T, Inaba K, Demetriades D:Prevention of postoperative peritoneal adhesions: a review of the literature. Am J Surg 2011, 201:111-121.
Wallwiener M, Brucker S, Hierlemann H, Brochhausen C, Solomayer E, Wallwiener C:Innovative barriers for peritoneal adhesion prevention: liquid or solid? A rat uterine horn model. FertilSteril 2006, 86:1266-1276.
Muller SA, Weis C, Odermatt EK, Knaebel HP, Wente MN: A hydrogel for adhesion prevention: characterization and efficacy study in a rabbit uterus model. Eur J ObstetGynecolReprodBiol 2011, 158:67-71.
Celepl S, Kismet K, Kaptanoğlu B, Erel S, Ozer S, Celeplı P, Kaygusuz G, Devrım E, Gencay O, Sorkun K, Durak I, Akkuş MA. The effect of oral honey and pollen on postoperative intraabdominal adhesions. Turk J Gastroenterol.2011 ;22(1):65-72.
Yuzbasioglu MF, Kurutas EB, Bulbuloglu E, Goksu M, Atli Y, Bakan V, Kale IT. Administration of honey to prevent peritoneal adhesions in a rat peritonitis model.Int J Surg. 2009 ; 7(1):54-7
Emre A, Akin M, Isikgonul I, Yuksel O, Anadol AZ, Cifter C. Comparison of intraperitoneal honey and sodium hyaluronate-carboxymethylcellulose (Seprafilm) for the prevention of postoperative intra-abdominal adhesions. Clinics (Sao Paulo). 2009; 64(4):363-8.
Cnossen TT, Konings CJ, van der Sande FM, Leunissen KM, Kooman JP. Clinical effects of icodextrin in peritoneal dialysis. NDT Plus. 2008 Oct;1(Suppl 4):iv18-iv22. doi: 10.1093/ndtplus/sfn119.
Reed B, Robinson R. Postoperative Urinary Retention With Gross Vulvar Edema After Use of 4% Icodextrin. Mil Med. 2015 Jul;180(7):e858-60.
Nesbitt-Hawes EM, Zhang CS, Won HR, Law K, Abbott JA. Urinary retention following laparoscopic gynaecological surgery with or without 4% icodextrin anti-adhesionsolution. Aust N Z J ObstetGynaecol. 2013 Jun;53(3):305-9
Silver SA, Harel Z, Perl J. Practical considerations when prescribing icodextrin: a narrative review. Am J Nephrol. 2014;39(6):515-27.
Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015 Mar 6; 3:CD005083. Epub 2015 Mar 6.
Mohamed H, Salma MA, A Lenjawi B, Abdi S, Gouda Z, Barakat N, Elmahdi H, Abraham S, Hamza AH, Al Khozaei D, A Majid S, A MajidH,Abdini J, Al Jaber M, A Masseh F, Al Ali AA. The efficacy and safety of natural honey on the healing of foot ulcers: a case series. Wounds. 2015 Apr;27(4):103-14.
Kosternoy A, Bayumi EK. Use of Honey in Management of Diabetic Foot Infection: Patient’s Satisfaction and Outcome. Journal of Surgery 2015; 3(2-1): 42-47
Amaya R. Safety and efficacy of active Leptospermum honey in neonatal and paediatric wound debridement.J Wound Care. 2015 Mar;24(3):95; 97-103.
Nikpour M, Shirvani MA, Azadbakht M, Zanjani R, Mousavi E. The effect of honey gel on abdominal wound healing in cesarean section: a triple blind randomized clinical trial. Oman Med J. 2014 Jul;29(4):255-9.
Gethin GT, Cowman S, Conroy RM. The impact ofManuka honey dressings on the surface pH of chronic wounds. Int Wound J.2008 ;5(2):185-94.
Zhou J, Pi H, Zheng Y. Characteristics of abdominal cavity drainage fluid in Chinese patients without postoperative complications aftersurgery for gastrointestinal or retroperitoneal tumors. ClinInterv Aging. 2015 Jan 28;10:367-70.