A scoring scale for the adhesive process in experiment

Introduction. Postoperative peritoneal adhesion remains a common complication. The lack of uniform, pathogenetically justified scoring scales that consider the timing of the experiment hinders the comparability of results.
Aim. To develop a universal scoring scale for the adhesive process based on an analysis of existing scales.
Materials and methods. Eight scales (Mazuji, Leach, Atta, adhe/ADHE, Moreno, Binda, Shurygina et al., Akentyeva et al.) were analyzed. Criteria included vascularization, ability to separate, macroscopic structure, area, number, length, bowel deformation, and adhesion type.
Results (proposed scale). A scale for the early period (days 3–5) includes fibrin deposits, peritoneal layer involvement, and affected area (%). For the late period (≥14 days), criteria include structure (membranous/loose/dense), separation ability (traction/blunt/sharp), area, and histological type (membranous/stringy).
Conclusion. The proposed scoring scale standardizes adhesion assessment in experiments, accounts for pathogenesis and timing, and is applicable to any laboratory animal.

1. Markos’yan SA, Lysyakov NM. Etiology, pathogenesis and prevention of adhesion formation in abdominal surgery. Surgery news. 2018;26(6):735–744. (In Russ.) https://doi.org/10.18484/2305-0047.2018.6.735, https://www.elibrary.ru/ vubadw

2. Ten Broek RPG, Krielen P, Di Saverio S, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 2018;13:24. https://doi.org/10.1186/s13017-018-0185-2

3. Lang J, Ma D, Xiang Y, et al. Chinese expert consensus on the prevention of abdominal pelvic adhesions after gynecological tumor surgeries. Ann Transl Med. 2020;8(4):79. https:// doi.org/10.21037/atm.2020.02.53

4. Esber S, Etrusco A, Laganà AS, et al. Clinical outcomes after the use of antiadhesive agents in laparoscopic reproductive surgery. Gynecol Obstet Invest. 2023;88(6):325‒335. https://doi.org/10.1159/000534170

5. Sopuev AA, Kudayarov EE, Ormonov MK, et al. Experimental assessment of the effect of kanamycin, ceftriaxone, ciprofloxacin and gentamicin on the formation of adhesions in the abdominal cavity. Vestnik of KSMA named after I. K. Akhunbaev. 2021;2:44‒54. (In Russ.) https://elibrary.ru/hytwcj

6. Auzhanov DB, Aimagambetov MZh, Zhagiparova ZhA. The influence of azathioprine on the formation of adhesions in the abdominal cavity in an experiment. Surgery news. 2019;27(4):369‒378. (In Russ.) https://doi.org/10.18484/2305-0047.2019.4.369

7. Atta H, El-Rehany M, Roeb E, et al. Mutant matrix metalloproteinase-9 reduces postoperative peritoneal adhesions in rats. Int J Surg. 2016;26:58‒63. https://doi.org/10.1016/j.ijsu.2015.12.065

8. Mazuji MK, Kalambheti K, Pawar B. Prevention of adhesions with polyvinylpyrrolidone. Preliminary report. Arch Surg. 1964;89:1011‒1015. https://doi.org/10.1001/archsurg.1964.01320060079015

9. Allègre L, Le Teuff I, Leprince S, et al. A new bioabsorbable polymer film to prevent peritoneal adhesions validated in a post-surgical animal model. PLoS One. 2018;13(11):e0202285. https://doi.org/10.1371/journal.pone.0202285

10. Liu Y, Shu XZ, Prestwich GD. Reduced postoperative intra-abdominal adhesions using Carbylan-SX, a semisynthetic glycosaminoglycan hydrogel. Fertil Steril. 2007;87(4):940‒948. https://doi.org/10.1016/j.fertnstert.2006.07.1532

11. Ozturk E, Yilmazlar A, Berhuni S, et al. The effectiveness of local anesthetics in preventing postoperative adhesions in rat models. Tech Coloproctol. 2010;14(4):337‒340. https:// doi.org/10.1007/s10151-010-0644-6

12. Guler S, Cimen S, Hu Q, et al. Effects of mTOR Inhibitors in Prevention of Abdominal Adhesions. J Invest Surg. 2016;29(5):275‒281. https://doi.org/10.3109/08941939.2016.1149643

13. Bento SV, Nunes TA, Araújo ID, et al. Hyperbaric oxygenation on adhesions prevention after laparotomy in rats. Acta Cir Bras. 2018;33(9):824‒833. https://doi.org/10.1590/s0102-865020180090000011

14. Шурыгина И. А., Аюшинова Н. И., Шурыгин М. Г. Оценка эффективности и безопасности применения Adept для профилактики спайкообразования в брюшной полости в эксперименте. Новости хирургии. 2017;25(1):14‒19. https:// doi.org/10.18484/2305-0047.2017.1.14, https://www.elibrary.ru/yguauj

15. Laukka M, Hoppela E, Salo J, et al. Preperitoneal fat grafting inhibits the formation of intra-abdominal adhesions in mice. J Gastrointest Surg. 2020;24(12):2838‒2848. https://doi.org/10.1007/s11605-019-04425-4

16. Moreno Egea A, Aguayo Albasini JL, et al. Adhesion response to different forms of treating a peritoneal lesion: An experimental study in rats. Dig Surg. 1995;12:334–337.

17. Certificate of state registration of the computer program “Scoring scale of the adhesive process in an experiment” / Kotkov PA, Timofeeva EG, Oschepkova ES, Sigua BV, applicant and patent holder Federal State Budgetary Institution “V. A. Almazov National Medical Research Centre” of the Ministry of Health of the Russian Federation. No. 2025612290; publication date 28.02.2025.