Mesothelial morphology and organisation after peritoneal treatment with solid and liquid adhesion barriers--a scanning electron microscopical study.

Separation of traumatized tissue represents the only promising strategy in postoperative adhesion prevention, a relevant clinical problem after surgical intervention. In the present study scanning electron microscopy (SEM) and subsequent morphometry were used to analyse the tissue response to five commercial adhesion barriers. Standardised peritoneal lesions in Wistar rats were covered with solid and viscous barrier materials and semiquantitatively analysed 14 days postoperatively. Striking morphological differences in lesion surface organisation between the barrier groups became apparent with colonisation of the barrier by mesothelial cells to different degrees. Furthermore, the mesothelial cells showed either a normal or activated phenotype depending on the underlying biomaterial. These experiments demonstrate that the examination by SEM gives useful insights into the performance of barrier materials and the cellular processes of adhesion prevention, since mesothelial cells play an active role in the pathogenesis of adhesion formation.