title: Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: a prospective, randomized, blinded, controlled study in a rabbit model.
abstract: OBJECTIVE
  To determine, in a rabbit model, whether peritoneal exposure to dermoid cyst material produces inflammation and adhesions above control levels and whether saline lavage reduces the degree of peritoneal reaction.
  
  
  METHODS
  A prospective, randomized, blinded, controlled study of adhesion formation. Thirty New Zealand white female rabbits were assigned randomly to five experimental groups: [1] laparoscopy with intraperitoneal injection of human dermoid material, [2] laparoscopy with intraperitoneal injection of human dermoid material and subsequent lavage to clear all visible dermoid material, [3] laparoscopy with saline lavage, [4] laparoscopy with intraperitoneal injection of human follicular fluid (antigenic control), and [5] laparoscopy alone.
  
  
  METHODS
  Six weeks after initial laparoscopy, inflammation and adhesions were scored in several categories via visual assessment (range 0 to 15) and histologic microscopic evaluation (range 0 to 24). Data were evaluated using Kruskal-Wallis and Mann-Whitney U nonparametric tests.
  
  
  RESULTS
  For groups 1, 2, 3, 4, and 5, respectively, mean +/- SEM total inflammation-adhesion scores were 13.85 +/- 0.55, 2.90 +/- 1.15, 0 +/- 0, 1.50 +/- 1.00, and 0 +/- 0 for clinical evaluation and 16.83 +/- 1.22, 7.33 +/- 1.76, 0 +/- 0,0 +/- 0, and 0 +/- 0 for histologic evaluation. Using nonparametric tests, significant differences were found between groups in clinical and histologic scores.
  
  
  CONCLUSIONS
  Dermoid material produces a significant peritonitis. Results of the clinical evaluation demonstrate that saline lavage brings inflammation and adhesion formation close to control levels. However, results of the histologic evaluation suggest that the decrement in inflammation as a result of lavage may be less dramatic than that found by clinical evaluation.
authors.affiliation: University Health Center of Pittsburgh, Magee-Womens Hospital, Pennsylvania, USA.
authors.forename: E P
authors.initials: EP
authors.lastname: Fielder
authors.forename: D S
authors.initials: DS
authors.lastname: Guzick
authors.forename: R
authors.initials: R
authors.lastname: Guido
authors.forename: A
authors.initials: A
authors.lastname: Kanbour-Shakir
authors.forename: J S
authors.initials: JS
authors.lastname: Krasnow
mesh_terms: D000818:Animals; D003884:Dermoid Cyst / Q000150:complications* / Q000601:surgery*; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications* / Q000601:surgery*; D010532:Peritoneal Diseases / Q000209:etiology* / Q000517:prevention & control; D010533:Peritoneal Lavage; D010538:Peritonitis / Q000209:etiology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011817:Rabbits; D012421:Rupture; D000267:Tissue Adhesions / Q000209:etiology* / Q000517:prevention & control