Abstract

Background:
Peritoneal adhesions develop between organs and tissues. They are an intrinsic component of the recuperative mechanism of the body following surgical intervention or inflammation. N-acetyl cysteine is an affordable drug with a long history of safe usage and is commercially available. Dexamethasone is a long-acting synthetic corticosteroid exhibiting minimal mineralocorticoid action. The presence of a fluorine atom at C9 on the steroid ring is a defining characteristic.

Aim:
This study aimed to conduct a comparative analysis of the effects of N-acetyl cysteine against dexamethasone on enterotomy in felines.

Methods:
The efficacy of three substances—N-acetylcysteine (NAC), dexamethasone, and normal saline was assessed for their potential to expedite intestinal healing post-surgery and inhibit adhesion formation. The study included 15 cats, evenly and randomly allocated into three groups. The intestines of cats were incised longitudinally (enterotomy) and subsequently closed with a simple continuous suture in each group. Upon completion of intestinal suturing, the surgical site in each group was irrigated with one of the three agents. The surgical wounds were then closed 3 days after surgery, and the abdomens of a whole cohort of cats were surgically reopened for direct observation. The animal administered the neutral solution displayed considerable intestinal adhesions. The cat administered with dexamethasone exhibited delayed healing along with minor adhesions. NAC-administered cats exhibited fast recovery with negligible edema.

Results:
CBC assessment on the third postoperative day indicated an elevation in white blood cells (WBCs) levels in all cats. By the seventh postoperative day, all cats exhibited a significant to moderate reduction in WBC, particularly associated with N-acetyl cysteine. Computed tomography scans revealed adhesions in groups 1 and 2; however, no adhesions were observed in the NAC-administered group.

Conclusion:
NAC has a beneficial effect on intestinal healing after surgery and adhesion prevention in this feline model.

Key words: Dexamethasone; Enterotomy; Hemoglobin; N-acetylcysteine; WBC.