Effectiveness of collagenase in preventing postoperative intra-abdominal adhesions

Introduction: The purpose of this study is to investigate the effectiveness of Collagenase clastridiopeptidase an enzyme preparation used in enzymatic debridement in preventing adhesions brought about by peritoneal damage. Methods: The study covers a total of 40 rats in 4 groups each having 10 rats. Group 1: The control group. Group 2: Normal saline group. Group 3: Sterile Novuxol® group. Group 4: The group where the intraperitoneal and systemic effects of sterile Novuxol® were investigated. Adhesion frequency and grades were scored on the post-op 11th day according to Granat. Blood work including hemoglobin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, and albumin level measurements were performed. Toxicity was investigated histopathologically through samples taken from the liver and the peritoneum from Group 4. Results: Adhesion frequency was found to be 80% on the right and 90% on the left for Group 1, while it was 50% on both left and right for Group 2, and 30% on the right and 10% on the left for Group 3. Adhesion stages were found to be 1: 2.35±1.42 for Group 1, 0.31±1.15 for Group 2, and 0.20±0.41 for Group 3. Adhesion stage of the Sterile Novuxol® Group was lower than all the other groups (p<0.05). Biochemical and hematological parameters were similar in all groups (p>0.05). Histopathological analysis revealed no hepatotoxicity. Conclusions: According to the results of our study, we believe that Sterile Novuxol® can be a good anti-adhesive agent considering its ease of use, non-toxicity, and effectiveness. © 2013 Surgical Associates Ltd.