Influence of Peritoneal Suture on the Formation of Abdominal Adhesions in Wistar Rats: Is Suturing Worthwhile?
- 1 Faculty of Medical Science and Health, Catholic University of S?o Paulo, S?o Paulo, Brazil
- 2 Faculty of Medical Science and Health, Catholic University of S?o Paulo, S?o Paulo, Brazil
- 3 Faculty of Medical Science and Health, Pontifical Catholic University of S?o Paulo, S?o Paulo, Brazil
- 4 Laboratory of Experimental Surgery, FCMS, PUC/SP, S?o Paulo, Brazil
Abstract
Purpose: The purpose of the present study was to determine the effect of peritoneal closure on the formation of abdominal adhesions by verifying their degree of damage on intestinal portions and the omentum with the abdominal wall. Given the different reports found in the literature concerning peritoneal closure mostly in obstetrics and gynecology, any objective information based on statistically tested results may be of great value in the everyday surgery practice. Material and Method: This is an experimental model on which a laparotomy is performed on the free cavity of the abdominal wall in growing rats. Young Wistar rats (approximately 1 month old) were operated through a long median xipho-umbilical abdominal incision. The animals were divided in 3 groups with fifteen rats each: in Group I, only the peritoneum was left open and all the other layers of the abdominal wall were closed; the rats in Group II had their peritoneums closed with unabsorbable cord (Prolene 4-0, Ethicon ? ). The abdominal wall of the rats in Group III (control) was only opened up to the musculature. The peritoneum, which remained intact and closed, was carefully prodded with the grip of tweezers to avoid lesions and/or perforations in the peritoneum. Results: There were no deaths nor incisional dehiscence and/or hernias among the animals. Nine animals of Group I presented adhesions (60%), whereas there were adhesions in all the fifteen animals of Group II (100%). In Group III adhesions were found in two animals (13%). The percentage of adhesions in Group II was significantly higher than those observed in Groups I and III ( p < 0.0001 ). Adhesions were mostly formed by the abdominal omentum. It was not observed any effect of the procedure on viscera. Conclusion: The experimental model that was suggested is appropriate for the establishment and study of peritoneal adhesions. The rate of adhesions found in the Group II was significantly higher ( p < 0.0001 ) than the rate observed in the Group I and Group III , suggesting tha t peritoneum suture can play a important role in the adhesion processes.
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