Effect of surgical adhesion reduction devices on the propagation of experimental intra-abdominal infection.
OBJECTIVE
The use of certain surgical adhesion reduction devices where there is a risk of concomitant bacterial contamination potentiates intra-abdominal infection.


METHODS
Evaluation of adhesion reduction devices in an experimental model of intra-abdominal infection.


METHODS
Experimental animal model.


METHODS
Adhesion reduction devices were administered at the time of bacterial challenge.


METHODS
Animal mortality rate, abscess formation, and bacterial counts in peritoneal fluid and blood cultures.


RESULTS
The use of bioresorbable membrane adhesion reduction devices in the presence or absence of antibiotic therapy did not alter the disease process as compared with appropriate control groups. However, adhesion reduction gels prepared from sodium hyaluronate and carboxymethylcellulose chemically modified with carbodiimide or ferric ion complexed sodium hyaluronate increased the incidence of peritonitis in treated animals. Gel formulations containing diimide-modified carboxymethylcellulose did not have this effect.


CONCLUSIONS
The use of certain adhesion reduction devices resulted in the propagation of intra-abdominal infection in an experimental rat model. This outcome was dependent on the composition of the device employed. The use of adhesion reduction devices should be tested in appropriate models of infection where there is the risk of concomitant bacterial contamination.
Tzianabos
A O
AO
Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA. atzianabos@channing.harvard.edu
Cisneros
R L
RL
Gershkovich
J
J
Johnson
J
J
Miller
R J
RJ
Burns
J W
JW
Onderdonk
A B
AB
D018784:Abdominal Abscess / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D000818:Animals; D001202:Ascitic Fluid / Q000382:microbiology; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001769:Blood / Q000382:microbiology; D002266:Carboxymethylcellulose Sodium; D005782:Gels; D006820:Hyaluronic Acid; D008297:Male; D008567:Membranes, Artificial; D010671:Phenylurea Compounds; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000517:prevention & control*
D001672:Biocompatible Materials; D005782:Gels; D008567:Membranes, Artificial; D010671:Phenylurea Compounds; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium