The Effect of Topical Application of 0.1% Betamethasone Ointment on the Peritoneal Adhesion and Inflammation Following Laparotomy: A Histopathological Animal Experiment

Adhesion band is one of the most important challenges after the operation. Regarding to the use of corticosteroid medications in inflammatory conditions, no studies have been conducted on the topical application, even though limited success have been reported with the systemic therapy. Since the systemic therapy of corticosteroids has its own limitation, the present study was designed to investigate the effect of using topical betamethasone on the prevention of peritoneal adhesion in an animal model. A total of 24 rats were randomly divided into two groups (control and betamethasone) and underwent laparotomy. Then, the adhesion was induced with the abrasion of dry gauze on the small intestine in both groups. In the betamethasone group, 0.1% betamethasone ointment was applied on the site of abrasion. After the 14 days, the animals were sacrificed, laparotomy was then performed with a U-shaped incision, and the number and location of the adhesions were reported. Histological parameters such as inflammatory reactions and collagen precipitations were evaluated, and neovascularization, abnormal mucosal proliferation, foreign body granulation, fibroblastic maturation were also observed. The results showed that the mean number of adhesions in the betamethasone and control groups were 1.08 and 1.17, respectively. Though betamethasone reduced the number of adhesions, the decrease was not statistically significant. Likewise, the results of histopathological evaluations showed no significant differences between the two groups (P>0.05). Our study demonstrated that the local application of betamethasone ointment in a single dose after laparotomy could not be effective in preventing peritoneal adhesion and inflammatory processes. Further investigations with larger sample sizes treated with higher doses of corticosteroids are required to find better the effects of topical betamethasone ointment on the peritoneal adhesion and inflammation following laparotomy.