[Prevention of peritoneal adhesions to intraperitoneal prostheses. An experimental study in pigs]. 2006

Juan A Martín-Cartes, and Salvador Morales-Conde, and Juan M Suárez-Grau, and Manuel Bustos-Jiménez, and Hisnard Cadet-Dussort, and María Socas-Maciás, and Francisco López-Bernal, and José M Alamo-Martínez, and Juan D Tutosaus-Gómez, and Salvador Morales-Méndez
Servicio de Cirugía General, Unidad de Cirugía Laparoscópica. Hospitales Universitarios Virgen del Rocío, Sevilla, España. jumarcar@telefonica.net

BACKGROUND The aim of this study was to investigate the effect of fibrin glue and hyaluronidase gel on the prevention of postoperative peritoneal adhesions to intraperitoneal prostheses. METHODS Twenty pigs, divided in two groups, were included. In all animals, four implants (4 x 4 cm) were placed: two polypropylene mesh implants were placed in an upper location and two polytetrafluoroethylene (PTFE) implants (Dualmesh Plus Corduroy) were placed in a lower position. Implants located in the right side of the animals were painted with fibrin glue (group A, n = 10) or with hyaluronidase gel (group B, n = 10). After 5 weeks, the animals were sacrificed and the results (number and grade of intraperitoneal adhesions, histological data on prosthesis integration, such as mesothelialization, fibroblast infiltration, vessel neoformation, etc.) were evaluated. RESULTS Intraperitoneal adhesions decreased in implants painted with fibrin glue and hyaluronidase gel compared with untreated implants. When right-sided adhesions formed, they were looser and in many animals, the implants were completely peritonized. Integration of the prostheses was not affected by either fibrin glue or hyaluronidase gel. CONCLUSIONS Adhesion formation can be reduced after abdominal surgery. The reduction achieved in this study was greater in the quantity than in the consistency of the adhesions. The results with hyaluronidase gel were moderately superior to those obtained with fibrin glue. Hyaluronidase gel has the advantage of being inexpensive.

UI MeSH Term Description Entries
D010532 Peritoneal Diseases Pathological processes involving the PERITONEUM. Peritoneal Disease
D010537 Peritoneum A membrane of squamous EPITHELIAL CELLS, the mesothelial cells, covered by apical MICROVILLI that allow rapid absorption of fluid and particles in the PERITONEAL CAVITY. The peritoneum is divided into parietal and visceral components. The parietal peritoneum covers the inside of the ABDOMINAL WALL. The visceral peritoneum covers the intraperitoneal organs. The double-layered peritoneum forms the MESENTERY that suspends these organs from the abdominal wall. Parietal Peritoneum,Peritoneum, Parietal,Peritoneum, Visceral,Visceral Peritoneum,Parametrium,Parametriums
D011126 Polypropylenes Propylene or propene polymers. Thermoplastics that can be extruded into fibers, films or solid forms. They are used as a copolymer in plastics, especially polyethylene. The fibers are used for fabrics, filters and surgical sutures. Propene Polymers,Propylene Polymers,Hostalen,Marlex,Marlex Polypropylene,Polypro,Polypropylene,Prolene,Polymers, Propene,Polymers, Propylene,Polypropylene, Marlex
D011138 Polytetrafluoroethylene Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. FEP,Fluon,Politef,Polytef,TFE,Teflon,Expanded PTFE,Fluoroplast,GORE-TEX,Goretex,PTFE,Tarflen,GORE TEX,PTFE, Expanded
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006821 Hyaluronoglucosaminidase An enzyme that catalyzes the random hydrolysis of 1,4-linkages between N-acetyl-beta-D-glucosamine and D-glucuronate residues in hyaluronate. (From Enzyme Nomenclature, 1992) There has been use as ANTINEOPLASTIC AGENTS to limit NEOPLASM METASTASIS. Hyaluronidase,Duran-Reynals Permeability Factor,GL Enzyme,Hyaglosidase,Hyaluronate Hydrolase,Wydase,Duran Reynals Permeability Factor,Factor, Duran-Reynals Permeability,Hydrolase, Hyaluronate,Permeability Factor, Duran-Reynals
D000267 Tissue Adhesions Pathological processes consisting of the union of the opposing surfaces of a wound. Adhesions, Tissue,Surgery-Induced Tissue Adhesions,Surgical Adhesions,Adhesion, Surgery-Induced Tissue,Adhesion, Surgical,Adhesion, Tissue,Adhesions, Surgery-Induced Tissue,Adhesions, Surgical,Surgery Induced Tissue Adhesions,Surgery-Induced Tissue Adhesion,Surgical Adhesion,Tissue Adhesion,Tissue Adhesion, Surgery-Induced,Tissue Adhesions, Surgery-Induced
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001672 Biocompatible Materials Synthetic or natural materials, other than DRUGS, that are used to replace or repair any body TISSUES or bodily function. Biomaterials,Bioartificial Materials,Hemocompatible Materials,Bioartificial Material,Biocompatible Material,Biomaterial,Hemocompatible Material,Material, Bioartificial,Material, Biocompatible,Material, Hemocompatible
D013526 Surgical Mesh Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal. Mesh, Surgical,Meshes, Surgical,Surgical Meshes

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