The effect of fibrin glue on intraperitoneal contamination in rats treated with systemic antibiotics.
Intraperitoneal fibrin sealant lowers septic mortality in a rat model of peritoneal contamination (2 x 10(6) organism inoculum) at the cost of increased late intraabdominal abscesses. This study utilized parenteral antimicrobials to determine if the protective effect of intraperitoneal fibrin could be achieved without increasing the late abscess formation rate. One hundred and fifty-five rats were divided into four groups. Gelatin capsules containing various dilutions of feces (10(10) CFU/ml) and barium sulfate were placed into the abdomen in all groups. Group I controls had no antibiotics or fibrin. In group II, the capsule was surrounded by a solution of cryoprecipitate, thrombin, and calcium (fibrin "glue"). Groups III (no fibrin, antibiotics) and IV (fibrin, antibiotics) received a broad-spectrum cephalosporin intramuscularly postoperatively and then daily. Surviving rats were sacrificed on the tenth postoperative day. At a moderate volume of fecal inoculum (0.3 ml), fibrin reduced mortality from 100% in the control group to 0% in treated animals (P less than 0.001) that did not receive antibiotics. Abscesses formed in 10% of the surviving fibrin-treated rats which were implanted with 0.1 ml of inoculum. In the 0.2 and 0.3 ml inoculum groups substantially more abscesses occurred (75 and 70%, respectively). The protective effect of fibrin was not manifested in the antibiotic-treated rats since no deaths occurred in either group. At higher and lower inoculum doses, no significant differences between fibrin and control groups were observed in mortality or abscess formation, whether or not antibiotics were given.(ABSTRACT TRUNCATED AT 250 WORDS)
Schwartz
R J
RJ
Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.
Dubrow
T J
TJ
Rival
R A
RA
Wilson
S E
SE
Williams
R A
RA
D000038:Abscess / Q000517:prevention & control; D000818:Animals; D015313:Cefotetan / Q000627:therapeutic use*; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D008297:Male; D010529:Peritoneal Cavity / Q000382:microbiology; D010532:Peritoneal Diseases / Q000517:prevention & control*; D010538:Peritonitis / Q000188:drug therapy; D051381:Rats; D011919:Rats, Inbred Strains
D015718:Fibrin Tissue Adhesive; D015313:Cefotetan