Abstract | BACKGROUND: Intraperitoneal adhesions cause significant morbidity. They occur after peritoneal trauma, which induces oxidative stress with production of inflammatory cytokines, peroxidized proteins (carbonyls) and lipids ( aldehydes). This study aimed to investigate if carbazate-activated polyvinyl alcohol (PVAC), an aldehyde-carbonyl inhibitor, can reduce intraperitoneal adhesions in an experimental model. MATERIAL AND METHODS: Male Sprague-Dawley rats (n=110) underwent laparotomy, cecal abrasion and construction of a small bowel anastomosis. They either were treated with intraperitoneal instillation of PVAC or were sutured with PVAC-impregnated sutures. Thromboelastography analysis was performed using human blood and PVAC. The lipid peroxidation product malondialdehyde (MDA) and inflammatory cytokines IL-1β and IL-6 were quantified in peritoneal fluid. At day 7, bursting pressure of the anastomosis was measured and adhesions were blindly scored. RESULTS: PVAC in human blood decreased the production of the fibrin-thrombocyte mesh without affecting the coagulation cascade. MDA, IL-1β and IL-6 were increased after 6h without significant difference between the groups. PVAC-impregnated sutures reduced intraperitoneal adhesions compared to controls (p=0.0406) while intraperitoneal instillation of PVAC had no effect. Anastomotic bursting pressure was unchanged. CONCLUSIONS: Intervention with an aldehyde-carbonyl inhibitor locally in the wound by PVAC-impregnated sutures might be a new strategy to reduce intraperitoneal adhesions.
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Authors | F Fredriksson, F Sellberg, T Bowden, T Engstrand, D Berglund, H E Lilja |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 52
Issue 11
Pg. 1853-1858
(Nov 2017)
ISSN: 1531-5037 [Electronic] United States |
PMID | 28196659
(Publication Type: Journal Article)
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Copyright | Copyright © 2017 Elsevier Inc. All rights reserved. |
Chemical References |
- Cytokines
- Hydrazines
- carbazic acid
- Polyvinyl Alcohol
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Topics |
- Anastomosis, Surgical
(adverse effects)
- Animals
- Cecum
(surgery)
- Cytokines
(metabolism)
- Disease Models, Animal
- Hydrazines
(pharmacology)
- Laparotomy
(adverse effects)
- Male
- Peritoneum
(drug effects, surgery)
- Polyvinyl Alcohol
(pharmacology)
- Rats
- Rats, Sprague-Dawley
- Sutures
(adverse effects)
- Tissue Adhesions
(prevention & control)
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