Objective: 

Postoperative adhesion formation is a consequence of wound healing and sometimes can result in severe complications. Despite all the preventive measures and agents, this problem has still not been eliminated completely. The aim of this study was to evaluate the effect of TNF-alpha inhibition on the development of postoperative uterine adhesions.

Methods: 

Twenty one female Wistar-Albino type rats were used in this study. The rats were randomly divided into three groups as sham-operated, adhesion and adhesion plus the TNF-alpha inhibitor etanercept. A lower midline abdominal incision was performed and a standard uterine lesion was created by electrocauterization in the adhesion control and etanercept treated groups. Starting immediately after adhesion induction, the treatment group received daily intraperitoneal injections of 2 mg/kg etanercept for a total of 3 days. At day 7, peritoneal washing fluids of rats were obtained for the determination of TNF-alpha levels. Then all of the rats were sacrificed and uterine adhesions were staged according to the Leach scoring system. Uterine tissue samples were harvested for biochemical and histopathological evaluation.

Results: 

The total adhesion score and tissue malondialdehyde levels were found to be increased whereas superoxide dismutase and glutathione peroxidase activities decreased significantly in the adhesion control group (P<0.05 vs. sham-operated animals). TNF-alpha inhibition, significantly reversed these findings (P<0.05 for all vs. adhesion control group). Additionally, in the etanercept-treated group, TNF-alpha levels of the peritoneal washing fluid were also significantly lower than the adhesion control group.

Conclusions: 

Anti-TNF-alpha therapy reduces the prevalence of peritoneal and uterine tube adhesion formation in rats possibly by suppressing TNF-alpha production as well as limiting oxidative stress.