Page 59 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences
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                                Postoperative adhesion prevention with a new barrier
Histology
After scoring the adhesions transverse sections of the wound area
including underlying musculature were fixed in 10% neutral buffered
formalin for 24 hours. After routine tissue processing sections were cut
at 4 to 6 μm and stained with hematoxylin and eosin. The formation
of neoperitoneum was assessed by microscopic examination of the
sections. In addition we investigated whether the adhesion barriers 3 were completely absorbed or had any remains in the abdominal wall. The
grade of inflammation was assessed using a semiquantitative scoring system, the inflammation grading scale. Grade 1 on this scale represents a mild inflammatory reaction with giant cells, occasional scattered lymphocytes, and plasma cells. Grade 2 represents a moderate reaction with giant cells and increased admixed lymphocytes, plasma cells, eosinophils and neutrophils. Grade 3 represents a severe inflammatory reaction with microabscesses present [14].
Statistical analysis
The Shapiro-Wilk test was used to confirm normal distribution of the data; percentage adhesion formation and Zühlke-score is presented in mean values with standard deviations. The groups were compared using Chi-square, one-way ANOVA-testing and post-hoc Dunnett tests. All data was two-sided tested and reported p-values are considered significant if less than 0.05. Statistical analysis was performed using PSAW statistical software package, version 17 (IBM SPSS statistics).
Results
No wound infection, bowel obstruction or peritonitis was observed and all groups were comparable for weight during the experiments. One animal in the 1.2ml PVA/CMC group died within 24h of the initial operation. Necropsy showed no intra-abdominal cause of death.
Experiment 1:
All animals in the PVA/CMC gel groups showed a significant reduction in adhesion formation compared to the control group. The mean
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