Use of the polytetrafluoroethylene surgical membrane for control of intra-abdominal adhesions

The new polytetrafluoroethylene (PTFE) surgical membrane is specifically designed to prevent adhesion formation. The present study was planned in order to evaluate the effectiveness of the PTFE surgical membrane as a parietal peritoneal substitute. Furthermore, the effects of the suture material used to implant the membrane under different operating conditions (clean or contaminated surgery) were also evaluated. One hundred-eighty rats were divided into 9 groups and underwent the following surgical procedures: Group 1: removal of a parietal peritoneum patch, which was left unrepaired; Group 2: a similar peritoneal defect was covered with the PTFE membrane by 8 polypropylene sutures; Group 3 (control group): only the 8 polypropylene suture were placed on the margin of the standard peritoneal defect; Group 4: the same procedure as in Group 2, using as sewing material PTFE sutures; Group 5 (control group): only the 8 PTFE sutures were placed on the margin of the standard peritoneal defect; Group 6, 7, 8 and 9: the same procedures as in Group 2, 3, 4 and 5 respectively, adding division and subsequent reanastomosis of the caecum. Animals of each group underwent a second laparotomy 10 days or 3 months after surgery for evaluation of the extent and density of adhesions, and of the intraperitoneal organ involvement. Histological examination of adhesions which formed was then carried out. No adhesions developed in rats of group 1, while they were always present in all the other groups. Under clean surgery, the adhesions were limited to the margin of the peritoneal defect, while under contaminated surgery they formed also on its central portion. The PTFE surgical membrane itself caused variations neither of the extent and density of adhesions which developed nor of the magnitude of intraperitoneal organ involvement. The type of suture material used to implant the membrane had no effect on adhesion formation.