The influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions.
BACKGROUND
The formation of adhesions following abdominal surgery is a well known problem. In previous studies we demonstrated the efficacy and safety of intraperitoneally applied phospholipids in order to prevent adhesion formation. This study evaluates the influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions.


METHODS
In 40 Chinchilla rabbits adhesions were induced by median laparotomy, standardized abrasion of the visceral and parietal peritoneum in defined areas of the ventral abdominal wall and the caecum. The animals were randomly divided into four groups. They received either phospholipids 3.0% or normal saline (NaCl 0.9%) (5 ml/kg body weight). In 50% of the rabbits we simulated intraperitoneal bleeding by administration of blood (1.5 ml/kg body weight). The other half served as control group. Ten days following the operation the animals were sacrificed and adhesion formation was assessed by computer aided planimetry and histopathologic examination.


RESULTS
The median adhesion surface area in the NaCl-group (n = 9) amounted to 68.72 mm2, in the NaCl+Blood-group (n = 10) 147.68 mm2. In the Phospholipid (PhL)-group (n = 9) the median adhesion surface area measured 9.35 mm2, in the PhL+Blood-group (n = 9) 11.95 mm2. The phospholipid groups had a significantly smaller adhesion surface area (p < 0.05).


CONCLUSIONS
Again these results confirm the efficacy of phospholipids in the prevention of adhesions in comparison to NaCl (p = 0.04). We also demonstrated the adhesion preventing effect of phospholipids in the presence of intraperitoneal blood.
Butz
Nick
N
Department of Surgery, Medical Faculty Rhenish-Westphalian Technical University, Aachen, Germany. Nbutz@ukaachen.de
Müller
Stefan A
SA
Treutner
Karl-Heinz
KH
Anurov
Michail
M
Titkova
Svetlana
S
Oettinger
Alexander P
AP
Schumpelick
Volker
V
D000818:Animals; D001769:Blood; D002682:Chinchilla; D004195:Disease Models, Animal; D006470:Hemorrhage / Q000150:complications*; D007263:Infusions, Parenteral; D007813:Laparotomy / Q000009:adverse effects; D010743:Phospholipids / Q000008:administration & dosage*; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D010743:Phospholipids