Prevention Of Postoperative Adhesion Formation By Discontinuous Intraperitoneal Injection Of Carboxy-aminon

Objective: To compare the effects by applying discontinuously intraperitonealinjection and disposable peritoneal lavage of carboxy-amino icodextrin in preventingpostsurgical peritoneal adhesions in the rat.Materials and Methods:32SD rats were equally randomized into four groupsreceiving no further treatment (control,group A), disposable peritoneal lavagecarboxy-amino icodextrin (group B), discontinuously intraperitoneal carboxy-aminoicodextrin (group C), discontinuously intraperitoneal saline (goup D). Denovoexperimental adhesions were induced by standardized trauma of the peritoneum andcecum. Ten days later all the rats were sacrificed, adhesion scores and incidence wereassessed by two independent surgeons. The histology studies of peritoneal adhesiontissues by HE，Masson′s stain were performed. TGF-β1expression was determinedby immunocytochemical staining and assessed by average optical density.Result (1) Groups treated with carboxy-amino icodextrin have less adhesion scoresthan the control and treated with saline.(P<0.05)(2)The adhesion tissue between theparietal peritoneum and cecum in group B had more inflammation cell，morefibroblast， more collagen, and more TGF-β1expression than group C(p<0.05).(3)The average optical density(AOD) in discontinuous intraperitoneal group is lowerthan the other groups,meanwhile the AOD of gorup A and D have no statisticallydifference(P<0.05).Conclusion (1) Barriers like carboxy-amino icodextrin can prevent postsurgical abdominal adhesions.(2) The effect of discontinuous intraperitoneal injection onsererity,icidence,surface area of adhesions and TGF-β1expression was lesspronounced than that of disposable peritoneal lavage with carboxy-amino icodextrinor saline.(3) It suggests that the effectiveness on preventing peritoneal adhesionsof barrier like carboxy-amino icodextrin can be greatly enhanced by discontinuousintraperitoneal injection.