title: Glove powder promotes adhesion formation and facilitates tumour cell adhesion and growth.
abstract: BACKGROUND
  The presence of foreign material in the abdominal cavity irritates the peritoneal surface, leading to an inflammatory response. This defensive mechanism can provoke adhesion formation. The same peritoneal defence cascade is thought to play a role in the process of intra-abdominal tumour recurrence. The aim of this study was to evaluate whether glove powder produced peritoneal adhesions in a rat adhesion model and whether it promoted intra-abdominal tumour recurrence in a rat tumour cell adhesion and growth model.
  
  
  METHODS
  A reproducible model that allowed semiquantitative scoring of adhesion formation or tumour load was used in three different groups of rats. One group was treated by intra-abdominal application of powder obtained from starch-powdered gloves, one by application of pure starch and in one group no powder was used.
  
  
  RESULTS
  Application of glove powder or pure starch on minimally and severely traumatized peritoneum gave rise to significantly greater adhesion formation and intra-abdominal tumour load than peritoneal trauma alone (both P < 0.001).
  
  
  CONCLUSIONS
  Starch-induced peritoneal trauma leads not only to more adhesion formation but also to increased adhesion and growth of tumour cells. Since good powder-free alternatives are available there is no longer any justification for the use of powdered gloves during intra-abdominal surgery.
authors.affiliation: Department of General Surgery, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: van den Tol
authors.forename: R
authors.initials: R
authors.lastname: Haverlag
authors.forename: M E
authors.initials: ME
authors.lastname: van Rossen
authors.forename: F
authors.initials: F
authors.lastname: Bonthuis
authors.forename: R L
authors.initials: RL
authors.lastname: Marquet
authors.forename: J
authors.initials: J
authors.lastname: Jeekel
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000818:Animals; D002455:Cell Division; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005932:Gloves, Surgical; D010537:Peritoneum; D011208:Powders / Q000009:adverse effects*; D051381:Rats; D011919:Rats, Inbred Strains; D013213:Starch / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000209:etiology*
chemical_list: D011208:Powders; D013213:Starch