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[The prevention of adhesions in surgery. A clinical review and experimental contribution]
B Palmieri1, G Gozzi, S Rosini
1Clinica Chirurgica I, Università degli Studi, Modena.
Background:
The well-known soft tissue healing properties in some rat models as well as the modulating fibroblasts activity of heterologous collagen led us to the hypothesis that it is possible to prevent the peritoneal adhesions in the rat by interposition of the collagen after peritoneal surgery.
Methods:
In this study, the use of Type I heterologous collagen in different physical forms (1% gel, lyophilized sponge, dehydrated film) for the postoperative peritoneal adhesions prevention has been evaluated. In the second part of the experiment; the 1% gel heterologous collagen including the recombinant tissue plasminogen activator (rtPA) has been applied.
Results:
The results of both the experiments don't show any improvement in the number and the quality of the adhesions.
Conclusions:
It is cannot be excluded that, increasing the rtPA concentration it is possible to obtain better results, but the great cost and its potential systemic toxicity are limiting factors for its widespread use in order to prevent peritoneal adhesions.