Nagelschmidt M, Minor T, Saad S
Second Department of Surgery, University of Cologne, Germany.
Am J Surg. 1998 Jul;176(1):76-80. doi: 10.1016/s0002-9610(98)00102-0.
Postoperative separation of the peritoneal surfaces is a promising approach for the prevention of adhesion formation. Instillation of polyethylene glycol 4000 (PEG) was recommended as an appropriate method.
In a time-course study in rats, efficacy and mode of action of PEG was investigated. Adhesions were induced by crushing of the cecum. Sixty animals were randomly allocated to three control groups with intraperitoneal instillation of 5 mL 0.9% NaCl and to three therapy groups treated with 5 mL 20% PEG. After 3, 7, and 21 days, adhesion grade, intraperitoneal leukocytes, and collagen incorporation into the adhesion strands were evaluated.
Administration of PEG resulted in a decrease of leukocytes by 43% (days 3 and 7), a reduction of the adhesion score by 85% (day 3), 77% (day 7), and 79% (day 21), and an impairment of collagen deposition by 54% (day 7) and 44% (day 21).
Coating the peritoneal surfaces with PEG is a highly effective measure to suppress the fatal sequence of posttraumatic inflammation, formation of initial adhesions, and their subsequent organization to strong permanent adhesion strands.
术后腹膜表面分离是预防粘连形成的一种有前景的方法。推荐使用聚乙二醇4000（PEG）灌注作为一种合适的方法。
在一项大鼠的时间进程研究中，对PEG的疗效和作用方式进行了研究。通过挤压盲肠诱导粘连形成。60只动物被随机分为三个对照组，腹腔内灌注5 mL 0.9%氯化钠溶液，以及三个治疗组，用5 mL 20% PEG进行治疗。在3天、7天和21天后，评估粘连等级、腹腔白细胞以及粘连条索中胶原的掺入情况。
给予PEG导致白细胞减少43%（第3天和第7天），粘连评分降低85%（第3天）、77%（第7天）和79%（第21天），胶原沉积减少54%（第7天）和44%（第21天）。
用PEG覆盖腹膜表面是一种非常有效的措施，可抑制创伤后炎症、初始粘连形成及其随后发展为牢固的永久性粘连条索的致命过程。
