Effect of Surgical Adhesion Reduction Devices on the Propagation of Experimental Intra-abdominal Infection

• Published in: Archives of surgery (Chicago, IL. 1960) Vol. 134; no. 11; pp. 1254 - 1259
• Main Authors: Tzianabos, Arthur O, Cisneros, Ronald L, Gershkovich, Julia, Johnson, Jeff, Miller, Robert J, Burns, James W, Onderdonk, Andrew B
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL American Medical Association 01.11.1999
• Subjects: Abdomen; Abdominal Abscess - microbiology; Abdominal Abscess - mortality; Abdominal Abscess - prevention & control; Animals; Ascitic Fluid - microbiology; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biocompatible Materials - therapeutic use; Biological and medical sciences; Blood - microbiology; Carboxymethylcellulose Sodium; Gels; Human bacterial diseases; Hyaluronic Acid; Infectious diseases; Male; Medical sciences; Membranes, Artificial; Phenylurea Compounds; Rats; Rats, Wistar; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue Adhesions - prevention & control; Infection; Animal model; Reduction; Treatment; Propagation; Abdominal disease; Surgery; Device; Complication; Experimental study; Adhesion; Abdomen
• ISSN: 0004-0010; 2168-6254; 1538-3644; 2168-6262
• DOI: 10.1001/archsurg.134.11.1254

HYPOTHESIS The use of certain surgical adhesion reduction devices where there is a risk of concomitant bacterial contamination potentiates intra-abdominal infection. DESIGN Evaluation of adhesion reduction devices in an experimental model of intra-abdominal infection. SETTING Experimental animal model. INTERVENTIONS Adhesion reduction devices were administered at the time of bacterial challenge. MAIN OUTCOME MEASURES Animal mortality rate, abscess formation, and bacterial counts in peritoneal fluid and blood cultures. RESULTS The use of bioresorbable membrane adhesion reduction devices in the presence or absence of antibiotic therapy did not alter the disease process as compared with appropriate control groups. However, adhesion reduction gels prepared from sodium hyaluronate and carboxymethylcellulose chemically modified with carbodiimide or ferric ion complexed sodium hyaluronate increased the incidence of peritonitis in treated animals. Gel formulations containing diimide-modified carboxymethylcellulose did not have this effect. CONCLUSIONS The use of certain adhesion reduction devices resulted in the propagation of intra-abdominal infection in an experimental rat model. This outcome was dependent on the composition of the device employed. The use of adhesion reduction devices should be tested in appropriate models of infection where there is the risk of concomitant bacterial contamination.Arch Surg. 1999;134:1254-1259-->