title: Experimental adhesion prophylaxis with recombinant tissue plasminogen activator.
abstract: The deposition of fibrin in the peritoneal cavity leads to fibrous adhesion formation. Recombinant tissue plasminogen activator (rtPA), delivered locally, was investigated as a method of preventing adhesion formation. Six standardised areas of peritoneal ischaemia were formed in each of 36 male Wistar rats randomised to three intraperitoneal treatments: (A) no treatment control; (B) carboxymethylcellulose gel; (C) rtPA-carboxymethylcellulose gel combination. At 1 week all animals underwent relaparotomy and the number of ischaemic sites with an adhesion counted by an independent observer. rtPA-treated animals formed fewer adhesions compared with gel alone or controls (median number of adhesions 1.5 versus 2.5 versus 5, P < 0.001, ANOVA). Intraperitoneal rtPA in a slow-release formulation is able to reduce adhesion formation significantly in an animal model and may prove to have clinical benefit.
authors.affiliation: Academic Surgical Unit, St Mary's Hospital, London.
authors.forename: M N
authors.initials: MN
authors.lastname: Vipond
authors.forename: S A
authors.initials: SA
authors.lastname: Whawell
authors.forename: D M
authors.initials: DM
authors.lastname: Scott-Coombes
authors.forename: J N
authors.initials: JN
authors.lastname: Thompson
authors.forename: H A
authors.initials: HA
authors.lastname: Dudley
mesh_terms: D000287:Administration, Topical; D000818:Animals; D002266:Carboxymethylcellulose Sodium; D004337:Drug Carriers; D005782:Gels; D007813:Laparotomy; D008297:Male; D010532:Peritoneal Diseases / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D011994:Recombinant Proteins / Q000627:therapeutic use; D000267:Tissue Adhesions / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D004337:Drug Carriers; D005782:Gels; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D002266:Carboxymethylcellulose Sodium