Effects of N-acetyl-L-cysteine on Postoperative Intrabdominal Adhesion in a Large Animal Model

Mechanisms that decrease oxidative stress and enhance peritoneal fibrinolysis reduce adhesions. N-acetyl-L-cysteine (NAC) is an antioxidant whose effect on peritoneal fibrinolysis in large animal model has not been established. The aims of this study were to investigate the ability of NAC to decreased adhesion in stablished model of serosal trauma in sheep. Design: Experimental study Animals: Eight healthy male sheep weighting 42.67 ± 2.31 kg were used in this study. Procedures: Established model of serosal trauma were used for adhesion induction. Each sheep intreated group (n=4) received NAC (150 mg/kg) intraperitonealy on operative day and Intravenous infusion during 7days after surgery. Animals in untreated group received normal saline instead of NAC. Blood samples for evaluation of the CBC, total protein and fibrinogen were obtained on perioperative day and at days 1, 2, 4, 7, 11 and 14 after surgery. Animals were killed 14 days postoperatively and Adhesion formation was scored macroscopically and histopathologically. Evaluation of CBC showed inflammation in 75% of animals in untreated group. CBC of animals in treated group was normal during the study. Measuring the fibrinogen concentration revealed significant differences between untreated and treated groups. Extensive of adhesion formation was 100% in all sheep in both 2 groups. Macroscopic evaluation of severity of adhesion and histopathological assessment of inflammation and fibrosis showed significant reduction in adhesion formation in treated animals. Conclusions and Clinical Relevance: Results of our study suggest a potential therapeutic use for N-Acetylcysteine in adhesion reduction and prevention in human and veterinary medicine.