Effects of laparoscopic lavage on adhesion formation and peritoneum in an animal model of pelvic inflammatory disease.
OBJECTIVE
To develop an animal model of pelvic inflammatory disease (PID) that simulates intraluminal tubal damage and adhesion formation seen in human PID, and to evaluate peritoneal effects of laparoscopic lavage with 1% povidone-iodine, 0.5% povidone-iodine, and 0.05% chlorhexidine gluconate solutions.


METHODS
Prospective, randomized, controlled study (Canadian Task Force classification I).


METHODS
Animal research operating room facility.


METHODS
Forty-five 1-year-old Pasteurella-free New Zealand white rabbits.


METHODS
Laparoscopy with instillation of one of five lavage solutions after bacterial inoculation with Neisseria gonorrhoeae, Bacteroides fragilis, Escherichia coli, and Peptococcus niger.


RESULTS
Histologic evaluation revealed significantly more peritoneal inflammation after lavage with all three solutions than after no lavage or lavage with normal saline. Gross adhesion formation was visible in only one rabbit after lavage with normal saline. One animal having lavage with 1% povidone-iodine died immediately after injection for sedation before laparoscopic lavage, and was not included in the final results.


CONCLUSIONS
Bacterial inoculation using an intrauterine insemination catheter did not produce clinical adhesions in 43 of 44 rabbits. Histologic evaluation revealed significantly more peritoneal inflammation in the lavage with povidone-iodine and chlorhexidine gluconate compared with no lavage or lavage with normal saline.
Roberts
Lisa M
LM
Departments of Obstetrics and Gynecology, Allegheny General Hospital, Pittsburgh, PA 15213, USA.
Sanfilippo
Joseph S
JS
Raab
Stephen
S
D000704:Analysis of Variance; D000818:Animals; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000494:pharmacology*; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D005260:Female; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D000292:Pelvic Inflammatory Disease / Q000601:surgery*; D010532:Peritoneal Diseases / Q000517:prevention & control*; D010533:Peritoneal Lavage / Q000379:methods*; D011206:Povidone-Iodine / Q000494:pharmacology*; D011336:Probability; D011817:Rabbits; D011897:Random Allocation; D012016:Reference Values; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000494:pharmacology*; D000267:Tissue Adhesions / Q000517:prevention & control*
D012965:Sodium Chloride; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine