[Prevention of peritoneal adhesions to intraperitoneal prostheses. An experimental study in pigs].
BACKGROUND
The aim of this study was to investigate the effect of fibrin glue and hyaluronidase gel on the prevention of postoperative peritoneal adhesions to intraperitoneal prostheses.


METHODS
Twenty pigs, divided in two groups, were included. In all animals, four implants (4 x 4 cm) were placed: two polypropylene mesh implants were placed in an upper location and two polytetrafluoroethylene (PTFE) implants (Dualmesh Plus Corduroy) were placed in a lower position. Implants located in the right side of the animals were painted with fibrin glue (group A, n = 10) or with hyaluronidase gel (group B, n = 10). After 5 weeks, the animals were sacrificed and the results (number and grade of intraperitoneal adhesions, histological data on prosthesis integration, such as mesothelialization, fibroblast infiltration, vessel neoformation, etc.) were evaluated.


RESULTS
Intraperitoneal adhesions decreased in implants painted with fibrin glue and hyaluronidase gel compared with untreated implants. When right-sided adhesions formed, they were looser and in many animals, the implants were completely peritonized. Integration of the prostheses was not affected by either fibrin glue or hyaluronidase gel.


CONCLUSIONS
Adhesion formation can be reduced after abdominal surgery. The reduction achieved in this study was greater in the quantity than in the consistency of the adhesions. The results with hyaluronidase gel were moderately superior to those obtained with fibrin glue. Hyaluronidase gel has the advantage of being inexpensive.
Martín-Cartes
Juan A
JA
Servicio de Cirugía General, Unidad de Cirugía Laparoscópica. Hospitales Universitarios Virgen del Rocío, Sevilla, España. jumarcar@telefonica.net
Morales-Conde
Salvador
S
Suárez-Grau
Juan M
JM
Bustos-Jiménez
Manuel
M
Cadet-Dussort
Hisnard
H
Socas-Maciás
María
M
López-Bernal
Francisco
F
Alamo-Martínez
José M
JM
Tutosaus-Gómez
Juan D
JD
Morales-Méndez
Salvador
S
D000818:Animals; D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006821:Hyaluronoglucosaminidase / Q000627:therapeutic use; D023421:Models, Animal; D010532:Peritoneal Diseases / Q000209:etiology / Q000517:prevention & control*; D010537:Peritoneum / Q000473:pathology; D011126:Polypropylenes / Q000627:therapeutic use; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D019736:Prostheses and Implants / Q000009:adverse effects*; D013526:Surgical Mesh; D013552:Swine; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*
D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D006821:Hyaluronoglucosaminidase