Page 87 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

kg)was administered subcutaneously. The abdomen was shaved
and cleaned with isopropyl alcohol 70%, after which a 3-cm midline
incision was made. The cecum was manipulated carefully to the outside
of the abdominal cavity and ligated just distal to the ileocecal valve
with a monofilament non-absorbable suture (4-0 Ethilon® Ethicon,
Inc., Somerville, NJ), maintaining the continuity of the bowel. Distally,
the cecum was punctured once with an 18-gauge needle. Some fecal
material was expressed through the puncture hole and cultured. The
cecum was replaced intra-peritoneally, and the abdominal wall and
skin were closed separately with running polyglycolic acid sutures (5-0
Safil®, B. Braun Melsungen AG, Melsungen, Germany). For resuscitation,
5 mL isotonic sodium chloride solution was administered, and animals
were placed under a heating lamp during the immediate post-operative 5 period.
Day 1: CLP and SWD model. The animals were anesthetized using isoflurane/O2 inhalation, and buprenorphine analgesia (0.05mg/kg) was administered subcutaneously. The abdomen was re-opened through the midline incision, and a culture swab of the abdominal cavity was obtained to confirm fecal peritonitis. The necrotic cecum was resected and the abdominal cavity rinsed with at least 20 mL of phosphate- buffered saline warmed to 37°C. The remaining cecum was abraded lightly with dry sterile gauze until punctate bleeding was observed. From the left anterior abdominal wall, a tissue strip of 0.5 x 2.0 cm, including peritoneum and muscle, was excised. Before closure of the abdomen, animals were assigned randomly to one of the three experimental groups. All animals received gentamicin (6 mg/kg intramuscular), buprenorphine (0.05 mg/kg subcutaneously), and isotonic sodium chloride solution (5 mL subcutaneously).
Day 1: application of PVA/CMC hydrogel. Animals in Group A served as the control group and received no additional treatment. Group B received 1 mL of PVA/CMC hydrogel, and Group C received 2 mL of hydrogel. The hydrogel was applied to the SWD and the abraded cecum. Finally, the abdominal wall and skin were closed separately with running polyglycolic acid sutures (5-0 Safil®).
Adhesion barrier and peritonitis
85