The effect of atorvastatin topical solution on preventing peritoneal adhesion in rats

Background: Peritoneal adhesion is a critical postsurgical complication in abdominal and pelvic surgeries. Due to their anti-inflammatory and fibrinolytic properties, statins are assumed to reduce peritoneal adhesions effectively. Our study aimed to investigate the effects of atorvastatin topical solution on preventing postoperative peritoneal adhesion in rats.Methods: Twenty male Wistar rats were used, and a 2–3 cm ventral midline incision was made under general anesthesia. The cecal abrasion model was used for the induction of peritoneal adhesion. Four groups of five rats were used: normal saline (negative control), hydrocortisone 1% (positive control), atorvastatin 1%, and atorvastatin 4%. All rats were sacrificed on the fifth postoperative day. The adhesions were scored as 1 to 4 microscopically and 0 to 5 macroscopically. A histopathological study was performed on the cecum and adherent bands. A blood sample was also taken for high-sensitivity C-reactive protein (hs-CRP) analysis on day 5.Results: Histopathological evaluation showed that microscopic and macroscopic adhesion significantly decreased after using atorvastatin 4% compared to the normal saline group (P = 0.032 and P = 0.008, respectively). Atorvastatin 4% also significantly reduced the level of hs-CRP after abdominal surgery (P = 0.001). The results with atorvastatin 1% were insignificant.Conclusion: Atorvastatin 4% topical solution effectively prevented rat peritoneal adhesion, possibly through its anti-inflammatory effects. More extensive animal studies with atorvastatin and other statins and large human clinical trials are still needed to confirm the applicability and accuracy of the present findings.