Fibrinolytic and Anti-Abdominal Adhesion Effects of Tannin Derivatives from <i>Rumex nepalensis</i> Spreng.: Activity-Guided Isolation and Evaluation in a Postoperative Rat Model

Abdominal adhesions following surgical procedures are a significant cause of postoperative complications, including chronic pain, infertility, and intestinal obstruction. Preventing adhesion formation remains a critical focus of preclinical and clinical research. In this study, we evaluated the fibrinolytic and antiadhesive potential of extracts from four plant species: <i>Asphodeline lutea</i> (L.) Rchb., <i>Rheum ribes</i> L., <i>Rubia tinctorum</i> L., and <i>Rumex nepalensis</i> Spreng. Among these, <i>R. nepalensis</i> exhibited the highest fibrinolytic activity <i>in vitro</i>, and bioactivity-guided fractionation led to the isolation of two major compounds, cinnamtannin B1 (RN2) and epicatechin gallate (RN3). <i>In vitro</i> assays demonstrated that RN2 displayed stronger fibrinolytic activity than RN3. The most active extracts, fractions and compound were further evaluated in a rat model of surgically induced intra-abdominal adhesions. A subfraction containing both compounds significantly reduced adhesion formation. These findings indicate that the bioactive constituents of <i>R. nepalensis</i>, and potentially the other studied species, may contribute to developing novel antiadhesive therapies. Overall, the study highlights the therapeutic potential of plant-derived flavonoids, anthraquinones, and tannins in adhesion prevention and supports further preclinical investigations to optimize dosage, formulation, and delivery methods. These results provide a foundation for translating natural compounds into practical strategies to reduce postoperative adhesion-related complications.