Increased postoperative peritoneal adhesion formation after the treatment of experimental peritonitis with chlorhexidine.
OBJECTIVE
Chlorhexidine is known as a substance that produces adhesions. However, in an experimental model of peritoneal injury, lavage with chlorhexidine and saline solutions produced a similar number of adhesions. This study was designed to test the hypothesis that chlorhexidine gluconate 0.05% solution used for the treatment of peritonitis increases formation of postoperative peritoneal adhesions as compared to standard lavage with saline solution.


METHODS
Forty Wistar rats were randomly allocated to gastric or faecal peritonitis groups. In each group rats were further randomly subdivided into saline or chlorhexidine peritoneal lavage groups. After 30 days the rats were killed and intraperitoneal adhesions were evaluated by adhesion score and grading.


RESULTS
Adhesion scores were statistically significantly different between saline and chlorhexidine groups in both gastric and faecal peritonitis models. In the faecal peritonitis chlorhexidine group a 20% small bowel intussusception rate was observed, while there were no such complications in the other study groups. The conglomerate of organs formed by dense adhesions was present in 60% of cases when gastric peritonitis was lavaged by chlorhexidine and in only 10% when saline solution was used ( P<0.05). Neither chlorhexidine nor saline solutions have caused such dense adhesions in faecal peritonitis.


CONCLUSIONS
Peritoneal lavage with chlorhexidine gluconate 0.05% solution in the treatment of experimental peritonitis results in increased adhesion formation.
Maleckas
Almantas
A
Department of Surgery, Kaunas University of Medicine, Mickeviciaus 9, 3000 Kaunas, Lithuania. almantas_maleckas@yahoo.com
Daubaras
Virmantas
V
Vaitkus
Valdas
V
Aniuliene
Albina
A
Dirzinauskas
Evaldas
E
Rakauskas
Mindaugas
M
Pundzius
Juozas
J
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D002710:Chlorhexidine / Q000494:pharmacology*; D004195:Disease Models, Animal; D010533:Peritoneal Lavage / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000473:pathology; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000139:chemically induced*
D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine