title: Local tissue ischemia is not necessary for suture-induced adhesion formation.
abstract: BACKGROUND
  We investigated the hypothesis that local tissue ischemia is responsible for suture-induced adhesion formation.
  
  
  METHODS
  A total of 160 interrupted sutures were placed in the parietal peritoneum of 20 Wistar rats. The animals were randomized into an ischemia group, where the sutures were pulled tight and a non-ischemia group, where the sutures were tied as loose loops with air knots to avoid any local ischemia. The midline laparotomy was closed with a running suture. On postoperative day 10, adhesions to the sutures were counted.
  
  
  RESULTS
  There was no statistically significant difference in the number of adhesions forming to sutures with local ischemia (n = 66/80) versus sutures without local ischemia (n = 69/80).
  
  
  CONCLUSIONS
  We conclude that local tissue ischemia is not necessary for suture-induced adhesion formation and propose an additional mechanical mechanism to explain how suture knots can predispose to adhesiogenesis.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA, trajab@rics.bwh.harvard.edu.
authors.forename: Taufiek Konrad
authors.initials: TK
authors.lastname: Rajab
authors.forename: Christoph
authors.initials: C
authors.lastname: Brochhausen
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D007511:Ischemia / Q000150:complications* / Q000473:pathology; D007813:Laparotomy; D010537:Peritoneum / Q000098:blood supply* / Q000601:surgery*; D051381:Rats; D017208:Rats, Wistar; D013536:Suture Techniques / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000209:etiology* / Q000473:pathology