TITLE:
Influence of Peritoneal Suture on the Formation of Abdominal Adhesions in Wistar Rats: Is Suturing Worthwhile?
AUTHORS:
Nathália Andrade, Michel Vinagre, Luciana Canabarro, Willy Marcus França
KEYWORDS:
Abdominal Adherence; Incision Closure; Peritoneal Suture
JOURNAL NAME:
Surgical Science,
Vol.4 No.9,
September
10,
2013
ABSTRACT: Purpose: The purpose of the present
study was to determine the effect of peritoneal closure on the formation of abdominal
adhesions by verifying their degree of damage on intestinal portions and the
omentum with the abdominal wall. Given the different reports found in the
literature concerning peritoneal closure mostly in obstetrics and gynecology,
any objective information based on statistically tested results may be of great
value in the everyday surgery practice. Material
and Method: This is an experimental model on which a laparotomy is
performed on the free cavity of the abdominal wall in growing rats. Young Wistar rats (approximately 1 month old)
were operated through a long median xipho-umbilical abdominal incision. The
animals were divided in 3 groups with fifteen rats each: in Group I, only the peritoneum was left open and all the
other layers of the abdominal wall were closed; the rats in Group II had their peritoneums closed with unabsorbable
cord (Prolene 4-0, Ethicon?). The abdominal wall of the rats in Group III (control) was only opened up to the musculature.
The peritoneum, which remained intact and closed, was carefully prodded with
the grip of tweezers to avoid lesions and/or perforations in the peritoneum. Results: There were no deaths nor incisional
dehiscence and/or hernias among the animals. Nine animals of Group I presented adhesions (60%), whereas there were
adhesions in all the fifteen animals of Group II (100%). In Group III adhesions were found in two animals (13%). The
percentage of adhesions in Group II was significantly higher than those
observed in Groups I and III (p 0.0001). Adhesions were mostly
formed by the abdominal omentum. It was not observed any effect of the
procedure on viscera. Conclusion: The experimental model that was suggested is appropriate for the establishment
and study of peritoneal adhesions. The rate of adhesions found in the Group II was significantly higher (p
0.0001) than the rate observed in the Group I and Group III,
suggesting that peritoneum suture can play a important
role in the adhesion processes.