The role of polymeric synthetic materials in the development of postoperative adhesion of the peritoneum(experimental study)

Abstract

Background. Animal models for adhesions induction are heterogeneous and often poorly described. The objective of this study was to determine the impact of surgical trauma with the use of meshes and sutures on postoperative peritoneal adhesions. Methods. In this article we compare and discuss different models for inducing peritoneal adhesions and estimation of the adhesions after surgical trauma and foreign body in a randomized, experimental in vivo animal study with 60 Wistar rats. Animals were divided into four groups because we used four different standardized surgical techniques for peritoneal trauma: brushing of peritoneal sidewall only (Group 1), scarification of the parietal peritoneum and serosa of the cecum (Group 2), brushing as in the previous group and suturing peritoneal sidewall with Prolen (Group 3), brushing as in the second group and mesh were fixated on the peritoneal wall (Group 4). Results. Upon second look, there were significant differences in the adhesion incidence between the groups (p = 0.008). Analysis showed that parameters of adhesion process in Group 3 (86 %) and 4 (86 %) were significantly higher than in Group 2 (60 %) (p = 0.018, p = 0.004). There was no difference between Group 3 and Group 4 (p = 0.40). Conclusions. The presence of synthetic polymeric material in the abdominal cavity increases the prevalence and severity of the postoperative adhesion process of the peritoneum.

Keywords

• postoperative peritoneal adhesions
• peritoneal wound healing
• inflammatory response