Collagen-PVP, a collagen synthesis modulator, decreases intraperitoneal adhesions.
BACKGROUND
Adhesion formation in the peritoneal cavity is the most common cause of intestinal obstruction and secondary female infertility. A great effort has been dedicated to reduce adhesion formation because of the associated morbidity and its complications.


METHODS
This study was designed as a before-after comparative trial and included 14 rabbits, with a weight between 300 and 500 g. All rabbits were appendectomized and 1 month later laparotomized to assess adhesion formation. Rabbits were randomized into two groups, Group I (control group), with no intervention, and Group II (experimental group), treated with an intraperitoneal sponge of collagen-polyvinylpyrrolidone (Clg-PVP). The laparotomy procedure was repeated 1 month later for a new assessment of adhesion formation and histological evaluation by H-E and Masson staining.


RESULTS
Histological findings showed abundant infiltrate in the control group, which was mild in the experimental group. With the Masson stain the control group showed a significantly higher amount of collagen than the experimental group and the fibrous tissue was more compact. We found a mean number of adhesions of 3.29 +/- 1.98 for the control group, which decreased to 2.57 +/- 0.79 after the second laparotomy. For the experimental group the mean number of adhesions decreased from 1.86 +/- 0.90 to 0.71 +/- 0.49 after the second laparotomy, with no statistical difference between both groups before Clg-PVP application, but a significant statistical difference after the implantation of Clg-PVP (Student's t test; P < 0.001, two-tailed).


CONCLUSIONS
Collagen-polyvinylpyrrolidone decreases the incidence and size of intraabdominal adhesions after secondary adhesion formation after appendectomy.
Cervantes-Sánchez
Carlos R
CR
Department of Surgery, School of Medicine, Universidad Panamericana, A.C. Donatello 75, Insurgentes-Mixcoac, 03920, Mexico City, Mexico. ccervans@mx.up.mx
Olaya
Enrique
E
Testas
Manuel
M
Garcia-López
Norberto
N
Coste
Gabriel
G
Arrellin
Gerardo
G
Luna
Adrián
A
Krötzsch
Fernando Edgar
FE
D000818:Animals; D001062:Appendectomy / Q000009:adverse effects; D003094:Collagen / Q000037:antagonists & inhibitors / Q000096:biosynthesis / Q000627:therapeutic use*; D005260:Female; D008297:Male; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D011205:Povidone / Q000627:therapeutic use*; D011817:Rabbits; D055502:Secondary Prevention; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology / Q000517:prevention & control / Q000601:surgery
C120488:collagen-PVP; D003094:Collagen; D011205:Povidone