Prevention of intraabdominal adhesion using rifampicin alone or in combination with oxidized regenerated cellulose following ovariohysterectomy in rats

This study aimed to evaluate the efficacy of rifampicin, administered alone or in combination with oxidized regenerated cellulose (Surgicel), in preventing postoperative intra-abdominal adhesions following ovariohysterectomy (OVH) in a rat model. Thirty-two female Wistar rats underwent OVH and were randomly assigned to four groups: a control group treated with saline (C), a Surgicel application group (S), a rifampicin administration group (R), and a combination group receiving both Surgicel and rifampicin (S+R). The development of adhesions was evaluated macroscopically and histopathologically on postoperative day 28. Additionally, immunohistochemical staining for TNF-α and immunofluorescence staining for VEGF were performed to assess inflammatory and angiogenic responses, respectively. Macroscopic and histopathological assessments revealed that rifampicin application (R) significantly reduced the intensity and severity of adhesion formation compared to the control. Interestingly, the S group exhibited adhesion rates comparable to the control, while the S+R group demonstrated a moderate decrease in adhesions. Immunohistochemical and immunofluorescence findings corroborated the macroscopic observations, indicating that rifampicin may attenuate the inflammatory and fibrogenic responses associated with adhesion formation. Rifampicin alone shows promise in reducing the formation and severity of intra-abdominal adhesions post-OVH. The combination of Surgicel and rifampicin did not yield a synergistic effect, as Surgicel application alone did not demonstrate significant efficacy in adhesion prevention. These findings suggest that while Surgicel is beneficial for haemostasis, caution should be exercised due to its potential contribution to adhesion formation. Further investigation is warranted to elucidate the pharmacokinetic and cellular mechanisms by which rifampicin might inhibit adhesion formation following abdominal surgery.