A Comparative Analysis of the Various Methods of Inducing Postoperative Abdominal Adhesion in Mice

Abstract

Background and Objective: Postoperative abdominal adhesion (POA) leading to intestinal obstruction
remains to be a significant morbidity for patients. Several methods for the prevention of POA have not
reached significant acceptance owing to their cost and safety issues. At present, several molecular targets are being considered for their roles in the mechanism of POA formation. However, the development of an animal model with high predictive induction of POA would further our understanding of its molecular mechanism. This modeling study aimed to evaluate four methods of inducing POA in mice.

Methodology: Twenty male BALB/c mice were assigned to four groups. Group 1 (CPA Group) underwent cecal and parietal abrasion using surgical gauze. Group 2 (CRPA Group) underwent partial cecal resection and parietal abrasion using surgical blade. Group 3 (CPAS Group) underwent cecal resection with parietal abrasion using surgical blade and four-corner suturing. Group 4 (CPAP group) underwent cecal and parietal abrasion using sand paper. On Day 14, all mice underwent laparotomy under anesthesia and grading of postoperative abdominal adhesion. Mean score was used in adhesion grading and statistical analysis done using Wilcoxon Sum-rank Test (at p-value<0.05).

Results and Conclusion: Mean scores of CPAS and CPAP groups were higher than the other groups
(p=0.01). Mean scores of CPA and CRPA groups were not significantly different with each other (p=0.19). Significant and predictable formation of POA was noted with abrasion using four-corner suturing and sand paper. But, the sand paper method mimics the natural biological process of adhesion formation than suturing method. This modeling study showed that POA could be reproduced in mice with significant predictability using the sand paper method. With this study, the search for cheaper surgical agents to prevent POA can be encouraged using this method.