Prevention Of Postoperative Peritoneal Adhesion

Two experimental studies were carried out in rabbits to evaluate the effects of dextran, 5-fluorouracil and refined lard in the prevention of postoperative peritoneal adhesions. Intravenous pentobarbital sodium supplemented by intermittent ether inhalation was the anethesia of choice. In experiment I, the trauma was produced by incising and suturing the left uterine horn and resection of the serosa of the right horn. The length of incision, the surface area of serosa resected, the types and amount of suture material and size of needles used for each animal were all standardized. The preventive agents were instilled into the peritoneal cavity after completion of operation. The volume of agents was fixed on 15 ml. 5FU 50 mg or 32% Dextran 70(Hyskon) was given each to 9 animals and thawed lard was given to 7. Nine rabbits receiving no agent after operation served as controls. The animals were sacrificed at the end of 4 weeks postopera-tively. The abdominal wall was opened and the intraperitoneal adhesions were carefully evaluated. The adhesions were classified as dense, membranous and loose in the order of severity and scored accordingly.The more and severer were adhesions, the higher was the scoring. The even distribution of number of adhesions and the approximation of scores among animals of the control group indicate that the amount of trauma created in this experiment was satisfactorily controlled at a relatively stable level. The. rabbits of the lard group were eliminated from the final analysis and comparison on account of severe inflammatory changes of the peritoneal cavity observed in 3 of the 7 animals. Therefore, only rabbits of the Hyskon, 5FU and control groups were left for statistical evaluation. The highest adhesion scores were obtained in the control group, totalling 66.5 for the 9 animals and averaging 7.39 for each rabbit. The respective total and average scores were 18.5 and 2.06 for the Hyskon group and 21.5 and 2.39 for the 5FU group. The differences between control and Hyskon groups(P<0.001) and between control...