Page 57 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Postoperative adhesion prevention with a new barrier
working principle is based on hydroflotation, which means that damaged surfaces physically are separated during the critical period for adhesion formation [11, 12].
Adhesion experiment 1
The aim of experiment one was to find the ideal dose of PVA/CMC gel in
our rat model. All experiments were performed under aseptic conditions, 3 56 animals were operated. At the beginning of each experiment animals
were anaesthetized by inhalation of an isoflurane-oxygen mixture. The abdomen was shaved and cleaned with alcohol 70%. A skin incision of 4
cm in the midline was made, followed by a 3 cm incision through the linea
alba to open the abdominal cavity. Subsequently on both lateral sides of
the abdominal wall an area of 20 x 5 mm of parietal peritoneum was
excised including the superficial part of the underlying musculature. The
wound was closed using three absorbable sutures (5-0 polyglycolic acid).
All knots were double and fastened tightly to ensure local ischemia. At
the end of the procedure PVA/CMC gel was applied equally on both sides
in different quantities per group. In group one 14 animals received 1.2ml
gel, group two 0.8ml gel, group three 0.4ml gel and group four was the
control group without PVA/CMC. After this procedure the abdomen and
skin were both closed with a running absorbable suture (5-0 polyglycolic
acid).
Adhesion experiment 2
The purpose of experiment two was to compare the ideal dose of PVA/ CMC gel from the first experiment to icodextrin 4%. The same procedure as in experiment I was followed and a parietal defect was created and closed in 30 animals. One group received 5ml icodextrin 4%, in another one 0.4ml PVA/CMC hydrogel was applied and in the control group again no agent was used. To prevent leakage of icodextrin 4% the abdomen was in addition to suturing sealed with tissue glue (Dermabond, Johnson & Johnson, Somerville NJ, USA).
Adhesion experiment 3
In this experiment 20 animals were operated following the same procedure as in the earlier two experiments applying 0.4 ml PVA/CMC
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