Long-term analysis of peritoneal plasminogen activator activity and adhesion formation after surgical trauma in the rat model.
OBJECTIVE
Recent literature has shown that a common pathway in postsurgical adhesion formation is a transient reduction in local plasminogen activator activity, shortly after peritoneal trauma. This deficit in fibrinolysis permits deposited fibrin to become organized into fibrous, permanent adhesions. Although adhesion formation is a process that continues beyond the first postoperative days, long-term analysis of this theory has not been performed.


METHODS
A standardized peritoneal adhesion model in the rat.


METHODS
Long-term analysis of the peritoneal fibrinolytic activity (extraction technique) was related to the extent of postsurgical adhesion formation, up to 1 year postoperatively.


RESULTS
Total and tissue plasminogen activator activity were significantly increased at days 3 and 8, and 1 month postoperatively. A mean adhesion percentage of 75% per peritoneal defect was found to persist throughout all evaluation times, which was directly related to the increase of fibrinolysis.


CONCLUSIONS
In contrast to the classical concept that adhesion formation is related to a reduction in fibrinolysis, an impressive increase of the fibrinolysis was found to be associated with the persistence of adhesions.
Bakkum
E A
EA
Leiden University Medical Center, The Netherlands.
Emeis
J J
JJ
Dalmeijer
R A
RA
van Blitterswijk
C A
CA
Trimbos
J B
JB
Trimbos-Kemper
T C
TC
D000818:Animals; D005260:Female; D005342:Fibrinolysis; D010532:Peritoneal Diseases / Q000209:etiology*; D010537:Peritoneum / Q000378:metabolism* / Q000601:surgery*; D010960:Plasminogen Activators / Q000378:metabolism*; D011183:Postoperative Complications; D011184:Postoperative Period; D051381:Rats; D017208:Rats, Wistar; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology
D010960:Plasminogen Activators