Effect of carboxymethylcellulose and a hyaluronate-carboxymethylcellulose membrane on healing of intestinal anastomoses in horses.

This research investigates the impact of sodium carboxymethylcellulose or a hyaluronate-carboxymethylcellulose membrane on the healing of small intestine in horses, finding that these substances could potentially decrease complications such as adhesions and excessive fibrin deposits.

Study Design and Methodology

• Eighteen healthy adult horses were enlisted in this study, where they were subjected to midline celiotomy and two jejunal resection-and-anastomosis surgeries.
• Post-surgery, 6 horses were treated with sodium carboxymethylcellulose (SCMC), and another 6 horses were treated with a hyaluronate-carboxymethylcellulose membrane (HA membrane). The remaining 6 horses were untreated and functioned as the control group.
• All horses were euthanatized 10 days following surgery for the examination of anastomoses healing. One anastomosis from each horse was used for histologic examination, and the other to determine intestinal bursting strength.
• The primary factors compared were intestinal bursting tension, serosal granulation tissue, serosal fibrin deposition, and the width of the fibrous seal at the anastomosis.

Findings

• In the control group, 3 horses experienced adhesions related to the anastomosis, whilst no treated horses exhibited this issue.
• The average thickness of fibrin deposited on the serosal surfaces was significantly less in the SCMC and HA membrane groups compared to the untreated horses.
• However, the mean thickness of the serosal granulation tissue, the width of the fibrous seal between inverted musculature, the inflammatory cell infiltrate scores, and the intestinal bursting tension did not differ significantly among the groups.

Conclusions and Implications

• The use of SCMC or the application of a HA membrane to small intestinal anastomoses in horses resulted in fewer adhesions and decreased fibrin deposition while maintaining normal anastomotic healing.
• For horses at an increased risk for intra-abdominal adhesions, the use of SCMC or the application of HA membranes may decrease the frequency of these complications without adversely affecting the healing of their small intestinal anastomoses.