Role of intraperitoneal propolis treatment in preventing postoperative peritoneal adhesions

Intra-abdominal adhesions are a dynamic, fibroproliferative, and inflammatory defense mechanism created by the peritoneum against damage (1).Fibrous adhesions occur 10 days after peritoneal injury and reach maximum levels in 2-3 weeks.The most important natural protection mechanism preventing the formation of adhesions is the fibrinolytic system.The balance between plasminogen activators and inhibitors is crucial in determining the formation of normal healing or adhesion formation.Therefore, plasminogen activator inhibitor-1 (PAI-1) is considered to be the most important factor in the development of adhesions, and a high concentration of PAI-1 is found in the peritoneal tissue of patients with accompanies large adhesions (2).Postoperative adhesions constitute an important problem for surgeons in terms of reoperations (3).Propolis is a honey bee product containing plant tissue resin (4).Mouse and rabbit studies have shown that the hydroalcoholic solution of propolis has an anti-inflammatory effect after its topical application, injection, or oral administration (5).This study aimed to evaluate the antiinflammatory and anti-oxidant properties of propolis and its effect on the fibrinolytic system in postoperative adhesions. MATERIAL AND METHODSThis study was conducted experimentally at Baskent University Laboratory of Experimental Animals.Prior to the study, the ethical committee approval (project number DA 13/58) was obtained.Thirty male young Sprague-Dawley rats (aged 6-9 months) weighing between 284 and 405 g (mean 342 g) were used in the study.The rats were kept at room temperature at 21-23°C during the study, provided standard food and water, and monitored for 21 days.Before the surgery, fasting was not performed to prevent stress factors in the animals.All surgical