Evaluation of oxidized regenerated cellulose for prevention of postoperative intraperitoneal adhesions |
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Authors: | Kazunori Nishimura Andre Bieniarz Robert M Nakamura Gere S diZerega |
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Institution: | (1) Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, California;(2) The Second Department of Surgery, Yamagata University School of Medicine, Yamagata, Japan;(3) Women's Hospital, Room L1014, 1240, N. Mission Road, 90033 Los Angeles, CA, USA |
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Abstract: | Oxidized regenerated cellulose (ORC) is widely used to cover the denuded mesothelium and to promote hemostasis. We evaluated
ORG in a rabbit model to assess the potential for adhesion reduction after uterine trauma and intestinal anastomosis. After
surgery, a second laparotomy was done on postoperative day 7 for macroscopic evaluation of adhesion formation. The traumatized
uterine horns wrapped in ORC had more numerous and higher grade adhesions compared with the non-surgical left, intact horns.
However, when compared to the contralateral uterine horn which underwent trauma without ORG, a significant decrease in the
grade of adhesion formation was noted. Rabbits undergoing intestinal anastomosis had the most pronounced degree of adhesion
formation. Typically, the area of healing was encapsulated in a fibrin clot with adhesions attached to adjacent viscera. When
ORC remained between the lesion and adjacent organs during mesothelial regeneration, adhesion formation decreased. However,
the soft, gelatinous mass of ORC was also an effective nidus for clot formation. Where post-and intra-operative ooze produced
a fibrin clot in the ORC, dense adhesions formed. |
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Keywords: | oxidized regenerated cellulose fibrin clot adhesion formation rabbit mesothelial regeneration |
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