title: Peritoneal closure over barbed suture to prevent adhesions: a randomized controlled trial in an animal model.
abstract: OBJECTIVE
  To compare adhesion formation and histological features of peritoneal closure and nonclosure over an intra-abdominally placed barbed suture.
  
  
  METHODS
  Single-blind randomized controlled trial (Canadian Task Force Classification I).
  
  
  METHODS
  Certified animal research facility.
  
  
  METHODS
  Eight nonpregnant rats.
  
  
  METHODS
  Abdominal cavities were entered via midline incision. Left and right parietal peritoneal surfaces were incised 1.5 cm long separately and stitched with unidirectional barbed suture material (3/0 V-Loc). The parietal peritoneum was approximated over the barbed suture using polypropylene suture material (7/0 Prolene) to embed the barbed suture (peritonization) on one side, and left open on the other side. The side of the barbed suture to be peritonized was allocated at random. On the postoperative day 32, all rats were sacrificed, adhesion formations on each side were macroscopically scored, and histological features were evaluated microscopically.
  
  
  RESULTS
  The median adhesion score was 2.00 (range, 1-4) on operative fields. There was no statistically significant difference in median adhesion score between the peritonized and nonperitonized sides (1.5 vs 2, respectively; p = .13). Microscopically, there were no statistically significant differences in median acute and chronic inflammation scores between the peritonized and nonperitonized sides (p = .58 and p = .45, respectively), but a significantly higher median fibrosis score on the peritonized side (3 vs 1.5, respectively; p = .02).
  
  
  CONCLUSIONS
  Based on the results of the present study in a rat model, barbed suture material might be associated with adhesion formation when used intra-abdominally, and these adhesions could not be prevented by peritonization.
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Api
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. Electronic address: muzaffer124@yahoo.com.
authors.forename: Muzaffer Seyhan
authors.initials: MS
authors.lastname: Cikman
authors.affiliation: Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Boza
authors.affiliation: Department of Cardiovascular Surgery, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat Bulent
authors.initials: MB
authors.lastname: Rabus
authors.affiliation: Department of Pathology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Onenerk
authors.affiliation: Department of Pathology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
authors.forename: Figen Vardar
authors.initials: FV
authors.lastname: Aker
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D010537:Peritoneum / Q000473:pathology*; D011126:Polypropylenes; D051381:Rats; D013537:Sutures; D000267:Tissue Adhesions / Q000517:prevention & control*
chemical_list: D011126:Polypropylenes
keywords: Adhesion; Barbed suture; Peritonization; Rat