| Abstract: | Postoperative pericardial adhesion formation occurs frequently after cardiac surgery and is an important cause of morbidity and mortality at the time of re-operation. As the number of patients undergoing cardiac surgery continues to increase, the number of potential candidates for re-operation is increasing exponentially. Despite ongoing improvements during cardiac re-operation surgery, the presence of pericardial adhesions not only adds to the surgery time but also increases the risk of life-threatening injuries to the heart, great vessels or previously placed coronary bypass conduits by obscuring the true anatomy.1Various methods and materials have been investigated to prevent or reduce the severity of postoperative adhesions in the retrosternal spaces and mediastinal structures. Fibrinolytic agents, histamine antagonists, anti-coagulants, anti-inflammatory drugs (corticosteroids, non-steroidal drugs), antibiotics, several natural physical barriers (heterologous pericardium, omentum, peritoneum, amnion, fibrin, gelatin, collagen and hyaluronic acid) and synthetic physical barriers (rubber, silicon-based materials, cellulose, polytetrafluoroethylene, polyvinyl alcohol and polyester derivatives) have been tried with variable success for such purposes.2-6 Unfortunately, despite continuous advances and research, to date there is no ideal method to prevent or reduce postoperative pericardial adhesion formation.Ankaferd blood stopper® (ABS) (Ankaferd Ilac Kozmetik AS, Istanbul, Turkey) is a folkloric medicinal plant extract. Ankaferd has been used as a blood-stopping agent against various types of bleeding. It has been approved by the Ministry of Health in Turkey for the management of bleeds due to external injury and dental surgery. It has also been used as a topical agent for the prevention of postoperative intra-abdominal fibrosis in experimental studies, and variable results have been obtained.7,8To the best of our knowledge, there is no report on the effect of Ankaferd in preventing postoperative pericardial adhesions to date. The present experimental study was designed to investigate the effect of intrapericardially administered Ankaferd on reducing postoperative pericardial adhesion formation in the rabbit model. |
