Peritoneal adhesions: prevention with the use of hydrophilic polymer coatings

Postoperative adhesions, especially peritoneal adhesions, pose an increasingly serious surgical problem. Modern surgical studies have generally attempted to deal with the problem after extensive surgical tissue damage has already occurred. This report focuses on our preliminary findings from exploratory laparotomies with canine and rat animal models, which suggest (1) that inadvertent and generally unappreciated serosal trauma may occur by contact adhesion as well as abrasion and drying mechanisms and (2) that hydrophilic polymer coatings, such as providone (polyvinylpyrrolidone), may be effective in protecting the peritoneal surface from damage. This opens up an important new approach to dealing with the problem: application of adhesive and lubricating tissue and surgical material coatings prior to surgical manipulations to limit tissue damage and thereby minimize postoperative complications. The implications of this study to many other surgical procedures may also be of considerable consequence.