Postoperative adhesion prevention using a statin-containing cellulose film in an experimental model

Abstract

Background: Intraperitoneal adhesions are a common problem in abdominal surgery. The aim of this study was to compare the effectiveness of Statofilm, a novel antiadhesive film based on cross-linked carboxymethylcellulose and atorvastatin, with that of sodium hyaluronate-carboxymethylcellulose (Seprafilm®) in the prevention of postoperative intraperitoneal adhesions in rats. Methods: One hundred male Wistar rats underwent a laparotomy and adhesions were induced by caecal abrasion. The animals were allocated to five groups: a control group with no adhesion barrier, Seprafilm® group, placebo group with a film containing carboxymethylcellulose without atorvastatin, and low- and high-dose groups with films containing carboxymethylcellulose and atorvastatin 0·125 and 1 mg per kg bodyweight respectively. Adhesions were classified by two independent surgeons 2 weeks after surgery. Caecal biopsies were obtained for histological evaluation of fibrosis, inflammation and vascular proliferation. Results: All antiadhesive film groups (Seprafilm®, placebo, low-dose and high-dose) had statistically significant adhesion reduction compared with the control group (P < 0·001, P = 0·015, P < 0·001 and P < 0·001 respectively). The low-dose Statofilm was superior to Seprafilm® in terms of adhesion prevention (P = 0·001). Adhesions were present in three-quarters of rats in the Seprafilm® group, but only one-quarter in the low-dose Statofilm group. Conclusion: The data suggest that the newly developed adhesion barrier Statofilm has better results than Seprafilm® in preventing postoperative adhesions in rats. A low-dose atorvastatin-containing film, such as Statofilm, could be evaluated for future clinical application. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.