Kayaoglu Huseyin Ayhan, Ozkan Namik, Hazinedaroglu Selcuk Mevlut, Ersoy Omer Faik, Koseoglu Resit Dogan
Department of General Surgery, Gaziosmanpasa University Medical School, Tokat, Turkey.
Surg Today. 2005;35(11):946-50. doi: 10.1007/s00595-004-3050-8.
This study assessed and compared the efficacy of two types of bioresorbable membranes in the prevention of postoperative adhesion under clean contaminated and bacterial peritonitis conditions using a cecal ligation and puncture model in rats.
Wistar albino rats (n = 72) were divided into six groups. Bacterial peritonitis was induced using a cecal ligation and puncture model in groups 2, 4, and 6. Groups 1, 3, and 5 served as controls for clean contaminated procedures in the absence of bacterial peritonitis. Groups 1 and 2 were the untreated clean contaminated and bacterial peritonitis groups and served as controls for the effect of the bioresorbable membranes in each condition. In groups 3 and 4, a 1.5 x 3 cm USP glycerol/sodium hyaluronate/carboxymethylcellulose membrane was wrapped around the cecal resection area and a 2 x 4 cm membrane was left under the incision. The oxidized regenerated cellulose membrane was similarly applied in groups 5 and 6. Four weeks later, the adhesions were evaluated. In addition, fibrosis and inflammation were observed histopathologically.
Adhesion development (P = .008), fibrosis (P = .008), and inflammation (P = .0001) differed among the groups. Both materials increased adhesion formation in the bacterial peritonitis condition. Increased fibrotic activity was detected in all material-applied groups under both conditions. In addition, more inflammation was detected in the groups that received the application of a material, especially in the presence of bacterial peritonitis.
Neither material prevented adhesions in clean contaminated conditions. Moreover, they increased adhesion formation in bacterial peritonitis.
本研究使用大鼠盲肠结扎和穿刺模型,评估并比较了两种生物可吸收膜在清洁污染和细菌性腹膜炎条件下预防术后粘连的效果。
将72只Wistar白化大鼠分为六组。在第2、4和6组中使用盲肠结扎和穿刺模型诱导细菌性腹膜炎。第1、3和5组作为无细菌性腹膜炎的清洁污染手术的对照组。第1组和第2组为未处理的清洁污染组和细菌性腹膜炎组,作为每种条件下生物可吸收膜效果的对照组。在第3组和第4组中,将一张1.5×3 cm的美国药典甘油/透明质酸钠/羧甲基纤维素膜包裹在盲肠切除区域周围,并在切口下方留置一张2×4 cm的膜。在第5组和第6组中同样应用氧化再生纤维素膜。四周后,评估粘连情况。此外,进行组织病理学观察以检测纤维化和炎症情况。
各组之间的粘连形成(P = .008)、纤维化(P = .008)和炎症(P = .0001)存在差异。在细菌性腹膜炎条件下,两种材料均增加了粘连形成。在两种条件下,所有应用材料的组均检测到纤维化活性增加。此外,在应用材料的组中检测到更多炎症,尤其是在存在细菌性腹膜炎的情况下。
在清洁污染条件下,两种材料均不能预防粘连。此外,它们在细菌性腹膜炎中增加了粘连形成。