Abstract
Background: Postoperative peritoneal adhesion formation causes a multitude of disorders, including
bowel obstruction and infertility. Methods: To test whether fibrin sealant inhibits adhesion formation, mice were given an intraperitoneal
injection of talc (to induce adhesions) after which sealant was administered. Seven
and 14 days later, the thickness of connective tissue between the fragmented mesothelium
and the abdominal muscle was measured. Results: At both 7 and 14 days after talc administration, talc-treated mice had a 6-fold increase
in connective tissue thickness over vehicle alone (P < .05). Although fibrin sealant alone failed to trigger peritoneal pathologic conditions,
administration of sealant to talc-treated mice inhibited connective tissue deposition
by 80% at 7 and 14 days (P < .05). Additionally, delaying fibrin sealant administration up to and including
72 hours after talc treatment results in comparable inhibition of connective tissue
deposition, as does treatment immediately after talc exposure. Conclusions: This study demonstrates that fibrin sealant inhibits peritoneal inflammation and
peritoneal adhesion formation with use of a quantitative assay of connective tissue
deposition. In addition, this is the first report to document the administration of
fibrin sealant into the closed abdomen. The success of these studies suggests that
fibrin sealant will block peritoneal adhesions when administered laparoscopically.
Finally, because fibrin sealant is therapeutic even when administered after the initiation
of peritoneal inflammation, it suggests that it may be efficacious in patients who
present with adhesions or those undergoing multiple operations. (Surgery 1999;125:53-9.)
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Article info
Publication history
Accepted:
June 2,
1998
Footnotes
☆Supported by NIH GM 55344 and Baxter Healthcare.
☆☆Reprint requests: Elizabeth Kovacs, PhD, Burn & Shock Trauma Institute Loyola University Chicago, 2160 South First Ave, Maywood, IL 60153.
Identification
Copyright
© 1999 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
