Counteracting postsurgical adhesions--the effect of combining oxidized regenerated cellulose and tissue plasminogen activator.

OBJECTIVE -- Postsurgical adhesion formation remains an unpredictable complication in operative surgery but is of special importance to the infertility surgeon. Recent reports on recombinant tissue plasminogen activator (tPA) and oxidized regenerated cellulose (ORC) have been promising. The present study set forth to verify these results and to explore possible synergistic effects of these two agents. METHODS -- Four groups of five rats each were subjected to a standardized caecal crush model and treated with ORC, tPA, a combination of these two or nothing. RESULTS -- The ORC group had significantly more postoperative adhesions than the other two groups (P < .05). This adhesion-promoting effect was mitigated when ORC was combined with tPA. The tPA group did not differ from the control group. CONCLUSIONS -- ORC and tPA were unable to decrease adhesion formation in rats with the current type of lesion. Nevertheless, tPA mitigated the adhesion-increasing effect of ORC. These findings underline the need for more research to establish the antiadhesion properties of ORC and tPA and lend support to the notion that all adhesions are not alike.