Effects of supplemental perioperative oxygen on post-operative abdominal wound adhesions in a mouse laparotomy model with controlled respiratory support.
BACKGROUND
Post-operative adhesion formation is a major clinical problem. Tissue oxygenation is one of the most important determinants in adhesion formation. The objective of this study was to investigate whether supplemental perioperative oxygen could reduce post-operative adhesion formation through increasing the peritoneal tissue oxygen tension (PitO(2)) in a mouse model.


METHODS
Adult C57BJ6 mice were randomly assigned to two groups: Group 1 (n = 20), Fraction of Inspired Oxygen (FiO(2)): 0.21; Group 2 (n = 20), FiO(2): 0.80. On day 0, over the course of the 90 min procedure including the 60 min of laparotomy, PitO(2) was continuously monitored. On day 7, a second laparotomy was performed to assess abdominal wound adhesions. Real-time RT-PCR was performed to measure expression levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) mRNA in peritoneal tissues.


RESULTS
The PitO(2) levels in Group 2 were significantly higher compared to Group 1 (P < 0.001) and controls (P < 0.003). There was no significant difference in the incidence of abdominal wound adhesions; however, the severity of adhesions was significantly reduced in Group 2 compared to Group 1 (P < 0.03). A significantly higher tPA/PAI-1 mRNA ratio was detected in Group 2 and the controls compared to Group 1 (P < 0.02 and P < 0.002, respectively).


CONCLUSIONS
Supplemental perioperative oxygen may help to reduce post-operative adhesion formation.
Matsuzaki
Sachiko
S
Université d'Auvergne - Clermont I, Faculté de Médecine, Centre d'Endoscopie et des Nouvelles Techniques Interventionnelles (CENTI), Clermont-Ferrand, France. sachikoma@aol.com
Canis
Michel
M
Bazin
Jean-Etienne
JE
Darcha
Claude
C
Pouly
Jean-Luc
JL
Mage
Gérard
G
D000005:Abdomen / Q000601:surgery*; D000007:Abdominal Injuries / Q000628:therapy*; D000818:Animals; D005260:Female; D007813:Laparotomy / Q000379:methods*; D051379:Mice; D008810:Mice, Inbred C57BL; D010100:Oxygen / Q000008:administration & dosage*; D019990:Perioperative Care / Q000379:methods*; D010537:Peritoneum / Q000378:metabolism; D058258:Serpin E2; D015843:Serpins / Q000096:biosynthesis; D000267:Tissue Adhesions / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000096:biosynthesis
D058258:Serpin E2; C511869:Serpine2 protein, mouse; D015843:Serpins; D010959:Tissue Plasminogen Activator; D010100:Oxygen