The Antiadhesive Effects of Bemiparin Sodium vs Hyaluronic Acid on a Rat Uterine Horn Adhesion Model: A Randomized Controlled Experimental Study

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Introduction: To determine the antiadhesive effects of bemiparine sodium compared to hyaluronic acid based jel on a standard adhesion formation model of rat uterine horn. Materials and Methods:Twenty non-pregnant female Sprague Dawley rats weighing 180-220 g were used to inflict a standardized model of adhesion formation on a rat uterine horn.The rats were randomized into four groups.Control group (group 1), bemiparin gr oup (group 2), HA (hyaluronic acid) group (group 3) and bemiparin+hyaluronic acid g roup (group 4).Each group consisted of 5 animals.In all groups, ten standardized lesions were inflicted on the right uterine horn using bipolar cauterization with 10 watt power.The uterine horns of 20 rats were evaluated macroscopically, microscopicall y and with immunohistochemistry.For macroscopic evaluation; "adhesion type", "adhesion tenacity", "extent of adhesions" and "total macroscopic adhesion score" were determined.For microscopic evaluation; inflammation and fibrosis formation was evaluated.Immunohistochemistry scoring was performed utilizing VEGF (Vascular Endothelial Growth Factor) and TGF-β1 (Transformic Growth Factor beta-1) markers.Results: Macroscopic adhesion scores, including "adhesion type", "adhesion extent" and " total macroscopic adhesion score" in the bemiparin+HA group (group4) was significantly lower than those in the control group (group1) and group HA (group3) (p<0.05).Among these three categories;bemiparin +HA (group4) had a significantly lower score than group HA (group3 ) in terms of adhesion type (p<0,01) and bemiparin group (group2) had a lower score than HA group (group3) in in terms of adhesion extent (p<0,05).There were no statistical differences across all four groups for microscopic inflammation, fibrosis and immu nohistochemistry staining. Conclusion:The combined use of bemiparin and HA may be effective in preventing macroscopic pelvic adhesion formation.Clinical trials on humans should be conducted for further recommendations.

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