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Background: Secondary peritonitis causes considerable mortality and morbidity. New strategies have been introduced like relaparotomy and temporary abdominal closure in the management of such persistent intra-abdominal infections. Materials and methods: Rats were divided into five groups each having ten animals. After induction of peritonitis, relaparotomies were done, and the abdomen was closed by different temporary abdominal closure techniques. After performing two relaparotomies during a 48-h period, all fascias closed primarily and incisional tensile strengths, hydroxyproline contents, and adhesions were measured on the following seventh day. Results: The median values of tensile strength and hydroxyproline concentrations were lowest in skin-only closure rats. Intraperitoneal adhesion scores were highest in Bogota bag closure group. Conclusion: Primary, Bogota bag, and polyprolene mesh closures seem to be safe in terms of early fascial wound healing. Although it is easy to perform, skin-only closure technique has deleterious effects on fascial wound healing probably due to fascial retraction. Interestingly, Bogota bag has caused increased intraperitoneal adhesion formation. © 2007 Springer-Verlag.

We studied the hemostatic and histopathological effects, and intra-abdominal adhesion scores of a new hemostatic agent, Ankaferd Blood Stopper (ABS), in an experimental liver injury model and compared it with regenerated oxidized cellulose. Thirty-six rats were randomly assigned to ABS, oxidized cellulose (Surgicel), and control groups (n=12, each). A wedge resection was performed on the left medial lobe of the liver. In the ABS group the liver surface was sprayed with ABS, whereas in the Surgicel group the liver was covered with double-layered oxidized cellulose. In the control group, saline solution was sprayed on the cut surface. The mean bleeding time was shorter in the ABS (23.08 +/- 6.99s) and Surgicel groups (47.91 +/- 8.21s) than in the control group (223.42 +/- 57.83s). No significant difference was found in the ABS and Surgicel groups in terms of preoperative and postoperative hematocrit (hct) values (P>0.05). Whereas there was no significant difference on day 7 (P>0.05), total adhesion score of ABS group was lower than both Surgicel (P

To assess the effectiveness of different doses of methylprednisolone on preventing intraabdominal adhesions established experimentally in rats. METHODS Forty female Wistar rats were divided into four groups: high-dose steroid (16 mg/kg), low-dose steroid (10 mg/kg), serum physiologic, and control. Following median laparotomy and procedure for adhesion formation in all rats, 16 mg/kg methylprednisolone (high-dose steroid group), 10 mg/kg methylprednisolone (low-dose steroid group), or serum physiologic (serum physiologic group) was administered into the intraperitoneal space, topically. No additional procedure was applied to rats in Group 4 (Control). All rats were sacrificed on day 15 postoperatively, and intraperitoneal adhesions were assessed according to Linsky's scale. RESULTS No significant differences were determined between the groups with respect to severity (p=0.867), degree (p=0.919), extent (p=0.876), and general scores (p=0.574) of adhesion formation. Wound infection rates were also similar in the four groups (p>0.05). CONCLUSION There was no difference in the effectiveness of different methylprednisolone doses, administered topically, in preventing intraabdominal adhesion formation, and furthermore, steroids do not prevent intraabdominal adhesion development. Sıçanlarda deneysel olarak oluşturulan karıniçi yapışıklıkların önlenmesinde topikal olarak uygulanan metilprednizolonun farklı dozlarının etkinliği değerlendirildi. GEREÇ-YÖNTEM: Çalışmada 40 adet dişi Wistar cinsi sıçan kullanıldı. Sıçanlar, yüksek doz steroid, düşük doz steroid, serum fizyolojik ve kontrol grubu olmak üzere dört gruba ayrıldı. Tüm sıçanlara yapılan median laparotomi ve yapışıklık oluşturulmasını takiben yüksek doz steroid uygulanan sıçan grubuna 16 mg/kg, düşük doz steroid grubuna 10 mg/kg metilprednizolon, serum fizyolojik grubuna da serum fizyolojik topikal olarak periton içine uygulandı. Son gruba ise ek bir uygulama yapılmadı. Sıçanlar 15. gün öldürüldü, karıniçi yapışıklıklar Linsky skalasına göre değerlendirildi. BULGULAR: Gruplar arasında yapışıklık şiddeti (p=0,867), yapışıklık derecesi (p=0,919), katılım yüzdesi (p=0,876) ve toplam skor (p=0,574) puanları açısından karşılaştırma yapıldığında istatistiksel bir fark bulunmadı. Yara enfeksiyonu açısından da anlamlı bir fark yoktu (p>0,05). SONUÇ: Topikal olarak uygulanan metilprednizolonun farklı dozlarının, karıniçi yapışıklıkların önlenmesindeki etkinlikleri arasında anlamlı fark bulunmadığı gibi, yapışıklıkların azaltılması üzerine de bir etkisi yoktur.

Peritoneal adhesions continue to be a significant cause of postoperative complications. The purpose of the present study was to investigate the effect of nitric oxide in preventing postoperative adhesion formation in rats. Three randomized groups of Sprague-Dawley rats were subjected to a standardized lesion by cecal abrasion and parietal peritoneal defect. 0.9% NaCl (control, group 1), L-arginine (300 mg/kg, group 2) and Nω-nitro arginine methyl ester (L-NAME; 25 mg/kg, group 3) were administered intraperitoneally before abdominal closure and during 3 consecutive days after surgery. Two weeks after surgery, a relaparotomy was performed and the extent of adhesion formation was determined. In groups 1 and 3 heavy adhesions were detected. In the L-arginine group, adhesion formation was significantly less than in the other groups (p < 0.05). This study showed that L-arginine reduced adhesion formation.

The aim of this study was to evaluate the role of neutrophil activation during adhesion formation in rat peritoneal adhesion model. A 1 x 1 cm area of peritoneum and transversus abdominal muscle was removed on the right lower abdominal wall of 14 rats. 14 days later, the animals underwent a second laparotomy. After the adhesion formations were evaluated, adhesion bands adhered to the peritoneal defect were excised, together with normal tissue 1 cm from the adhesion band. Myeloperoxidase and elastase activities were determined in peritoneal tissue samples excised during the first laparotomy (control group, adhesion bands adhered to the peritoneal defect (adhesion group) and peritoneal tissue excised during the second laparotomy 1 cm from the peritoneal defect (normal peritoneum group). Myeloperoxidase activity was significantly higher in the adhesion group that in both the control and normal peritoneum group (P < 0.001). Elastase activity in the adhesion significantly higher than in the control group (P < 0.001). The normal peritoneum group elastase activity was significantly higher than in the control group (P < 0.001), but significantly lower than in the adhesion group (P < 0.001). The increased activities of neutrophil activation markers in normal peritoneum tissues may suggest that the inflammatory reaction was not limited to the adhered peritoneum. The role of elastase inhibitors in preventing peritoneal adhesion should be determined in further studies.

Background. Postoperative intraperitoneal adhesion formation is a major cause of infertility, pain, intestinal obstruction, and subsequent intraoperative complication. We investigated the effects of L-arginine and pentoxifylline for preventing postoperative adhesion in rats., Methods. Forty Sprague-Dawley rats were subjected to a standardized lesion by serosal trauma of the uterine horn and parietal peritoneal defect. The agents were administered intraperitoneally at the end of surgery. The rats were assigned randomly into control (saline treated), L-arginine, pentoxifylline and L-arginine with pentoxifylline groups. Two weeks after surgery, a second laparotomy was performed and the extent of adhesion formation was determined. The data were analyzed by Mann Whitney U test., Results. In L-arginine and pentoxifylline administered groups, adhesion formation scores were significantly lower than the control group (p, Conclusion. This study showed that L-arginine and pentoxifylline administered at the end of surgery reduced adhesion formation.

Objective: To investigate the potential role of mast cell stabilisation in the prevention of post-operative adhesions. Design: Laboratory animal experiment. Setting: University hospital, Turkey. Subjects: Ninety Wistar albino rats. Intervention: Under anaesthesia, a lower midline laparotomy was performed, the caecum exposed and grasped until haemorrhage occurred. The rats were divided into three groups. Group 1, 2 and 3 were intra-peritoneally administered 1 ml of saline, disodium cromoglycate 5 mg/kg in 1 ml of saline and 10 mg/kg in 1 ml of saline, respectively thirty minutes prior to laparotomy and immediately subsequent to abdominal closure. They were later sacrificed, laparotomy repeated and the presence and extent of intraabdominal adhesions evaluated. Results: Adhesion scores were best in the high disodium cromoglycate dose group of rats (p < 0.05) and the number of degranulated mast cells was significantly low in this group (p < 0.05). Conclusion: Disodinm cromoglycate may be an effective agent for attenuating adhesion formation when administered in suitable doses.