Reduction of intraperitoneal adhesion formation by use of non-abrasive gauze.
BACKGROUND
Adhesion formation is potentially harmful. Surgical swabs may contribute to adhesions by trauma to the peritoneum. The purpose of this study was to evaluate whether standard surgical gauze (Medipres) has an adhesion-promoting effect, and to determine whether a soft textile (Fastsorb), used in the electronics industry, might be less traumatic and therefore lead to less adhesion formation.


METHODS
A reproducible rat model allowing semiquantitative scoring of adhesion formation was used. Three different adhesion models representing increasing degrees of peritoneal trauma (minimal, moderate and severe) were employed. The model inflicting minimal peritoneal trauma was combined with standardized rubbing of the peritoneum with surgical gauze or non-surgical textile.


RESULTS
Minimal peritoneal trauma resulted in a significantly lower mean adhesion percentage (21 per cent) than moderate (44 per cent) or severe (60 per cent) peritoneal trauma (P < or = 0.005). Rubbing of the peritoneum with surgical gauze after minimal peritoneal trauma induced significantly more adhesion formation (58 versus 23 per cent, P < 0.0001). After minimal peritoneal trauma, rubbing with surgical gauze produced significantly more adhesions than rubbing with non-surgical textile (63 versus 19 per cent, P < 0.0001). Moreover, rubbing the peritoneum with non-surgical textile after minimal peritoneal trauma did not induce any additional adhesion formation (35 versus 24 per cent, P = 0.23).


CONCLUSIONS
The extent of adhesion formation correlates significantly with the degree of peritoneal damage. Standard surgical gauze is traumatizing to the peritoneum and promotes adhesion formation whereas a less abrasive non-surgical textile does not.
van den Tol
M P
MP
Department of General Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
van Stijn
I
I
Bonthuis
F
F
Marquet
R L
RL
Jeekel
J
J
D000818:Animals; D010532:Peritoneal Diseases / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000517:prevention & control