Comparison of the Efficacy of Oral Simvastatin and Topical Simvastatin Solution in Decreasing Post-Laparotomy Adhesions in Rats

Abstract

Background: Intra-abdominal adhesions and their complications occur frequently after laparotomy. The aim of this study was to compare oral versus intraperitoneal administration of simvastatin in decreasing postlaparotomy adhesions in rat.
Methods: Thirty male Wistar albino rats were divided into three groups of ten. All the rats underwent laparotomy and induction of adhesions using the method of Meso-Stitch approximation of injured cecum and abdominal wall. One group received oral simvastatin (40 mg/kg) daily during two weeks before the laparotomy. In the two other groups, 2 ml of solution of simvastatin (40 mg/kg) or distilled water (as placebo) was spilled into abdomen before closing abdominal wall, respectively. After 14 days, all the rats were put under laparotomy again to be compared. Rates and grades of adhesions were assessed using Hoffman et al. and Lauder et al. Scale and histopathological reports.
Results: In placebo group, the grade II and III adhesion was seen in 2 and 8 rats, respectively. In local simvastatin group, there was no adhesion in 5 rats, and grade I and II adhesion was seen in 3 and 2 rats, respectively. In oral simvastatin group, 6 rats were without adhesion, and 3 cases with grade I and 1 case with grade II adhesion. The frequency and grade of adhesion were statistically different in simvastatin groups compared to the placebo group (P < 0.001), but not with each other.
Conclusions: Oral simvastatin for two weeks before the laparotomy can reduce post-laparotomy adhesion bands as well as local administration of simvastatin solution.