Intra-abdominal adhesions and their prevention by topical tissue plasminogen activator.
Recent work shows that a common pathway in adhesion production is a reduction in local plasminogen activator activity (PAA). This deficit permits deposited surface fibrin to become organized to fibrous adhesions. A rabbit model for adhesion formation was used to assess the effect of replacing the deficit with recombinant tissue plasminogen activator (rt-PA). Adhesions were produced by stripping peritoneum from corresponding parietal and visceral areas. One week later the adhesions were divided. Either rt-PA or placebo was applied to the divided adhesion. After a further week the animal was killed and the adhesions assessed. Sixty strips were performed. Fifty-five adhesions were produced (92%). Placebo gel was applied to 28 sides and rt-PA applied to 27. Twenty-two of the placebo group recurred (79%). Two of the rt-PA group reformed (7%, chi 2 = 20.883, P less than 0.001). Recombinant tissue plasminogen activator is an effective inhibitor of adhesion formation in the experimental animal.
Menzies
D
D
Department of Surgery, Westminster Hospital, London.
Ellis
H
H
D000287:Administration, Topical; D000818:Animals; D002429:Cecal Diseases / Q000517:prevention & control*; D004195:Disease Models, Animal; D005260:Female; D010537:Peritoneum / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D000267:Tissue Adhesions / Q000517:prevention & control; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator