Perioperative Lavage Promotes Intraperitoneal Adhesion in the Rat

Abstract

This study was designed to study the effect of peritoneal lavage solutions on postsurgical adhesion formation in rats undergoing laparotomy and standardized ischemic injury to the lateral peritoneum with sutures. This reproducible model enabled semiquantitative scoring of adhesion formation. Adhesions were induced in 33 adult female Wistar rats. The solutions RPMI medium, NaCl (0.9%), Viaspan(R) and both povidone-iodine (1%) and chlorhexidine (0.02%) in dilution were evaluated. In the control group that was operated upon (without peritoneal lavage), a mean adhesion percentage of 22.5% was scored. All solutions used for abdominal lavage in this rat model induced significantly (p = 0. 0001) more adhesions (40.6-70.8%). Not all solutions induced an equal effect. The results found in the present in vivo study correlate with observations in previous in vitro experiments i.e. exposure of peritoneal areas to lavage solutions enhances peritoneal activation and thus promotes intra-abdominal adhesion formation.