Mechanisms of adhesion development and effects on wound healing.
This paper reviews the evidence that glove powder plays an important role in adhesion formation and has adverse effects on the healing of abdominal incisional wounds. The underlying mechanisms leading to these adverse effects are beginning to be revealed. By affecting the mesothelial cell function, powder contamination disrupts the delicate balance of fibrin deposition and degradation, provoking adhesion formation, and interfering with wound healing. Studies are described showing that starch impairs incisional wound healing by its effect on the T cell-mediated immune system. Furthermore starch powder may act as a vector for endotoxin. This paper concludes that starch powder is harmful and its use in a hospital setting can no longer be supported.
Holmdahl
L
L
Department of Surgery, University of Gothenburg, Sweden.
D000005:Abdomen / Q000601:surgery*; D000818:Animals; D004731:Endotoxins / Q000009:adverse effects; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D005337:Fibrin / Q000187:drug effects / Q000378:metabolism; D005932:Gloves, Surgical / Q000009:adverse effects*; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology*; D011208:Powders / Q000009:adverse effects; D013213:Starch / Q000009:adverse effects*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D000267:Tissue Adhesions / Q000209:etiology; D014945:Wound Healing
D004731:Endotoxins; D011208:Powders; D005337:Fibrin; D013213:Starch