Studying the Effect of Local Solution of Clobetasol on Peritoneal Adhesion after Laparotomic Surgery in Rats
Soroush Noroozzadeh
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
Leila Ghafoor *
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
Noshin Sadat Mosavi
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
Hamidreza Banafsheh
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
Amirhosein Matini
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
Seyed Alireza Morovaji
Department of Surgery, Kashan University of Medical Sciences, Kashan, Iran.
*Author to whom correspondence should be addressed.
Abstract
Background and Objective: Adhesion is an important complication of abdominal and pelvic surgery. Applying corticosteroids reduces vascular permeability and releasing of cytokines and chemotactic factors. The current study has examined the effect of clobetasol solution on intra-abdominal adhesion in the rat after laparotomy.
Materials and Methods: 50 albino male rats with age of three months were undergoing laparotomy; the ileocecal abrasionas induced the peritoneal adhesion. The rats were randomly divided into 5 groups (10 rats per group): the first group was treated with 5 ml clobetasol 0.05%; the second group was treated with 5 ml clobetasol 0.025%; the third group was treated with 5 ml clobetasol 0.0125%; the fourth group was treated with 5 ml paraffin and fifth group (control) was no undergone under any treatment. After 14 days, the adhesion and histopathologic changes were compared between the groups. The rats that died for any reason were excluded from the study.
Results: From among 50 rats, 3 rats died in groups 3, 4 and 5. There was a significant statistic difference between the groups regarding adhesion severity (p = 0.018). In the case of integration of intervention groups (groups 1 to 3), there was a significant statistic difference in the amount and severity of adhesion, as well as the rate of inflammation and the extent of fibrosis among the groups (p = 0.028, p = 0.03, p = 0.002, p = 0.048) which was determined by Fisher's exact test.
Conclusion: The clobetasol solution can prevent the onset of adhesion after laparotomy in mice and reduce its intensity. Safety and the possibility of using clobetasol to prevent adhesion after abdominal surgery in humans require more clinical trials.
Keywords: Peritoneum, adhesion, laparotomy, clobetasol.