Human amniotic membrane versus topical simvastatin solution in reducing intestinal adhesion after laparotomy in rats

Introduction: Intra-abdominal adhesions are common complications that follow laparotomy are common, prompting surgeons to strive for their reduction. Simvastatin has been promising due to its fibrinolytic and anti-inflammatory properties, but human amniotic membrane (HAM) is a promising alternative option. Objectives: The current study compares the effects of amniotic membrane and topical simvastatin solution in reducing intestinal adhesions after laparotomy in rats. Materials and Methods: Thirty Wistar albino rats were divided into three groups (HAM, simvastatin and placebo). The rats underwent midline laparotomy, and optimal adhesions were induced using the meso-stitch approximation method. Before closing the abdomen, in group one, disinfected human amniotic membranes were used to cover the viscera. In the second and third groups, simvastatin solution and distilled water were deposited into the abdominal cavity, respectively. Two weeks later, a second laparotomy was performed to compare the degree of adhesion, using the Hoffmann quantitative and qualitative Lauder questionnaire and histological report. The data were analyzed using SPSS software. Results: The chi-square analysis was utilized for the clinical evaluation of adhesion severity across the three groups. The results showed a statistically significant difference between the three groups (P<0.0001). Statistical analysis to compare Lauder and Hoffman scores between the three groups showed that the degree of adhesion in simvastatin, HAM, and placebo groups had a statistically significant difference (P<0.0001). Conclusion: Our findings revealed that preventive human amniotic membrane for postoperative adhesion formation in rats resulted in better surgical and histological outcomes than simvastatin or placebo.