Preventing recurrent postoperative adhesions: an experimental study in rats.
A peritoneal lavage model, cyclic intraperitoneal lavage (CIPL), and other adhesion preventing methods with and without fibrinolytic agents were compared to a control group without treatment in an animal study. The adhesion-preventing effect was evaluated at the site of a standardized peritoneal defect (free peritoneal grafting, P) and at the laparotomy wound (L) of 60 rats (12 escape) after surgical lysis of primary adhesions during relaparotomy In five test groups with different treatments and in a control group without treatment recurrent adhesions were investigated during relaparotomy according to an adhesion grading scale with increasing severity (O-III). In the control group only severe adhesions grade II and III were observed. The five test groups showed different distributions of grade 0-II adhesions: compared to the control group a significant difference of the preventing effect was seen after CIPL with 1.36% glucose solution (as used for peritoneal dialysis) and after CIPL with Ringer's solution at the sites P and L, after a one-time irrigation with Ringer's solution only at the peritoneal graft P. Fibrinolytic agents used in CIPL or as single dose application failed to show an improvement compared to the control group.
Verreet
P R
PR
Department of Surgery, Heinrich-Heine-University, Düsseldorf, FRG.
Fakir
C
C
Ohmann
C
C
Röher
H D
HD
D000818:Animals; D015314:Dialysis Solutions / Q000627:therapeutic use; D008297:Male; D010532:Peritoneal Diseases / Q000473:pathology / Q000517:prevention & control*; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D011919:Rats, Inbred Strains; D012008:Recurrence; D013300:Streptokinase / Q000627:therapeutic use; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
D015314:Dialysis Solutions; D013300:Streptokinase