Chlorhexidine as a factor that promotes peritoneal adhesions in rats with induced peritonitis.

PURPOSE To investigate the effects of chlorhexidine on the formation of adhesions and dilation of the colon at the oral end of anastomosis in the presence of peritonitis. METHODS Peritonitis was induced in male Wistar rats by cecal ligation and puncture (CLP). Abdominal cavities were irrigated with tepid solutions containing 0.9% saline (SAL group; n=8) or 0.05% chlorhexidine (CHD group; n=8), after which colon anastomoses were performed. Control rats (n=8) were submitted to colon anastomoses but not to CLP. Animals were euthanised seven days after surgery and the incidence of adhesions, the degree of dilation of colon loops and an index were calculated to determine variables correlation. RESULTS No animals exhibited macroscopic signs of residual peritonitis or abdominal abscesses. Adhesions were observed in 75% of control and 100% of SAL and CHD animals. Dilation of intestinal loops at the oral end of anastomosis was observed in control (50%), SAL (57.2%) and CHD (66.7%) animals. The calculated index was 1.25 in group A; 1.86 in group B; and 2.0 group C. CONCLUSION Chlorhexidine promoted stronger adhesions and a greater dilatation of colonic loops than control group.

[1]  L. F. Moreira,et al.  New quantitative variables to measure postoperative pericardial adhesions. Useful tools in experimental research. , 2009, Acta cirurgica brasileira.

[2]  M. Wallwiener,et al.  Adhesion prophylaxis using a copolymer with rationally designed material properties. , 2009, Surgery.

[3]  Ö. Ekinci,et al.  Reduction of Postsurgical Adhesions in a Rat Model: A Comparative Study , 2009, Clinics.

[4]  A. Dietz,et al.  [The repair of abdominal defects in rabbits with Parietex and Surgisis meshes abdominal wall]. , 2008, Arquivos de gastroenterologia.

[5]  Hau D. Le,et al.  Inhibition of intra-abdominal adhesion formation with the angiogenesis inhibitor sunitinib. , 2008, The Journal of surgical research.

[6]  T. A. Nunes,et al.  Clinical and histological responses to laparoscopically-induced peritonitis in rats. , 2008, Acta cirurgica brasileira.

[7]  J. Fujimoto,et al.  Interferon-γ is a therapeutic target molecule for prevention of postoperative adhesion formation , 2008, Nature Medicine.

[8]  E. P. Dellinger,et al.  Randomized Trial Strategy in Patients With Severe Peritonitis: A Comparison of On-Demand vs Planned Relaparotomy , 2008 .

[9]  A. Odashiro,et al.  Laparoscopic Evaluation of Abdominal Adhesions With Different Prosthetic Meshes in Rabbits , 2008, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[10]  M. Kirschner,et al.  Polyvinyl alcohol gel prevents abdominal adhesion formation in a rabbit model. , 2007, Fertility and sterility.

[11]  J. Jeekel,et al.  Biology of the peritoneum in normal homeostasis and after surgical trauma , 2007, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[12]  H. Goor Consequences and complications of peritoneal adhesions , 2007 .

[13]  D. Gouma,et al.  Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis: a randomized trial. , 2007, JAMA.

[14]  R. Andersson,et al.  Long‐term follow‐up and cost analysis following surgery for small bowel obstruction caused by intra‐abdominal adhesions , 2007, The British journal of surgery.

[15]  R. Weigel,et al.  Formation and prevention of postoperative abdominal adhesions. , 2006, The Journal of surgical research.

[16]  C. Feo,et al.  Role of Peritoneal Lavage in Adhesion Formation and Survival Rate in Rats: An Experimental Study , 2006, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[17]  J. Pundzius,et al.  Increased postoperative peritoneal adhesion formation after the treatment of experimental peritonitis with chlorhexidine , 2004, Langenbeck's Archives of Surgery.

[18]  D. Kasper,et al.  CD4+ T Cells Regulate Surgical and Postinfectious Adhesion Formation , 2002, The Journal of experimental medicine.

[19]  C. Farquhar,et al.  Barrier agents for preventing adhesions after surgery for subfertility. , 1999, The Cochrane database of systematic reviews.

[20]  B. Risberg,et al.  Cost of bowel obstruction resulting from adhesions. , 1997, The European journal of surgery = Acta chirurgica.

[21]  B. Risberg Adhesions: preventive strategies. , 1997, The European journal of surgery. Supplement. : = Acta chirurgica. Supplement.