Effects of local therapeutics on prevention of postoperative abdominal adhesions: experimental study

ABSTRACT

Visceral adhesions following abdominal surgery create major challenges that motivated surgeons to test a multitude of maneuvers and agents for their effectiveness in minimizing adhesion formation. This problem was studied experimentally in rats by induction of intraperitoneal adhesions. The rats were divided into 3 groups The first was kept as control, Dextran solution was left in the peritoneal cavity of the second group, while in the third dexamethasone mixed with heparin in ringer's solution was left. In all groups, a standard cotton pellet was left in the abdomen before closure. After 15 days, the rats were reexplored and the grade of adhesions were recorded as well as the cotton pellet weight as an indicator for the amount of peritoneal reaction. The third group's agents have proved a superior antiadhesive effect, as the average grade of adhesion per animal was 1.6 [+1.19], compared with 1.85 [t = 1.19 in the second, and 2.6 [ +/- 0.99] in the first group. Also, the cotton pellet test showed 43.18% inhibition of adhesions in the third group and 37.78% in the second group as compared with the control group; but as Dextran has less side effects than cortisone and heparin, it is preferred as the first choice antiadhesive agent. The combination of cortisone and heparin are better reserved for selected cases with life threatening complications