Decreasing Abdominal Adhesions

Post-operative abdominal adhesions are a significant problem in horses, as they can lead to intestinal obstruction or strangulation. In recent years, a laparoscope is used to look into the abdomen and break down any adhesions that have formed seven to 10 days after the initial surgery. Unfortunately, in some foals, new adhesions form after second-look laparoscopy, but these are generally less common and less severe.

To combat new adhesions, compounds called absorbable barriers are being put into the abdomen after surgery. One, ferric hyaluronate gel (FeHA), has decreased adhesion formation in research animals.

Ludovic Bouré, DVM, MSc, Dipl. ACVS, ECVS, assistant professor of large animal surgery at the University of Guelph Ontario Veterinary College, recently compared the effectiveness of FeHA instilled after laparoscopic dissection of adhesions with dissection alone in healthy pony foals. The study's objective was to determine if FeHA would improve the outcome of second-look laparoscopy seven days after abdominal adhesions were experimentally created.

Adhesions were created at four sites on the jejunum in 12 healthy pony foals. Seven days later, the foals were split into two groups and taken back to surgery. Group 1 foals had a total of 22 adhesions, and Group 2 foals had a total of 20 adhesions. All adhesions were bluntly dissected, or sharply cut when necessary. Group 2 foals then received 300 mL of 0.5% FeHA instilled into the abdomen. Bouré points out that FeHA disperses well in pony abdomens. "FeHA will inhibit adhesion formation whether it is applied at the adhesion formation site or a remote site," Bouré said. Twenty-four days after the original surgery, all foals were taken back to surgery and their adhesion sites re-examined.

Results showed a statistically significant decrease in the number of adhesions on Day 24 compared to Day 7 in Group 1 (10 versus 22) and Group 2 (3 versus 20). However, Group 1 had significantly more adhesions than Group 2 on Day 24. This led to the conclusion that instillation of 0.5% FeHA into the abdomen after laparoscopic dissection of adhesions was more effective than dissection alone in pony foals.

Bouré is optimistic that FeHA will be used clinically in foals, but problems of volume and cost might prohibit its use in adults. Finally, there was no evidence of adverse effects of FeHA on the major organs, the blood, or serum biochemistry.

Bouré's current research, including development of a 3-D model of the equine carpus (knee), is profiled at

Landsdowne, J.L.; Bouré, L.P.; Pearce, S.G.; et al. American Journal of Veterinary Research, 65(5): 681-686, 2004.

About the Author

Susan Piscopo, DVM, PhD

Susan Piscopo, DVM, PhD, is a free-lance writer in the biomedical sciences. She practiced veterinary medicine in North Carolina before accepting a fellowship to pursue a PhD in physiology at North Carolina State University. She lives in northern New Jersey with her husband and two sons.

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