Effects of passive motion and early vs. delayed ambulation on adhesion formation in rat uterine surgery

The goal of our study was to assess the effects of unrestrained ambulation and of passive motion and delayed ambulation on the occurrence of adhesions after controlled uterine injuries, produced by conventional surgical techniques, in rats. A classic Pomeroy ligation was performed on the left uterine horn and a 1 cm x 3 mm rectangular flap hysterotomy on the right uterine horn in 48 rats, which were subsequently divided into four groups of 12 each. Group 1 served as controls and were allowed to ambulate without restriction following recovery from the anesthetic. Group 2 remained anesthetized for 12 hours, during which time each was passively moved from one lateral decubitus position to the opposite every 15 minutes. Group 3 were anesthetized for 12 hours and group 4 animals for 24 hours, following which unrestricted ambulation was allowed. All animals were killed 3 weeks after the operation and the left and right uterine horn adhesions were graded separately using a macroscopic system. The adhesion score of the left horn in group 2 animals (3.5) was significantly higher (P less than .025) than in the control animals (2.25). Group 3 animals had adhesion scores on the left (2.75), but did not differ significantly from controls (P greater than .05). Group 4 animals demonstrated significantly higher adhesion scores of the left uterine horn (3.3) than control animals. Group 2 animals, but not group 3 or group 4, had higher mean adhesion scores of the right uterine horn than control animals (P less than .005).(ABSTRACT TRUNCATED AT 250 WORDS)