Comparison between the Intraoperative Use of Polyvinyl Chloride Cover and Surgical Compresses for Preventing Postoperative Adhesions

• Published in: European surgical research Vol. 50; no. 1; pp. 44 - 55
• Main Authors: Akyol, C., Sozener, U., Ozgun, A., Karabork, A., Kuzu, I., Cakmak, A., Erkek, A.B., Erdemli, E., Kuzu, M.A.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2013
• Subjects: Abdomen - surgery; Animals; Female; Intraoperative Care - instrumentation; Original Paper; Polyvinyl Chloride; Rats; Rats, Wistar; Surgical Equipment - adverse effects; Tissue Adhesions - etiology; Tissue Adhesions - pathology; Tissue Adhesions - prevention & control; Rats; Inflammation; Adhesion formation; Surgery
• ISSN: 0014-312X; 1421-9921
• DOI: 10.1159/000348409

Background/Purpose: Surgical compresses used for retraction during major abdominal and pelvic procedures lead to postoperative adhesion formation resulting from damage to the visceral peritoneum. This study investigates whether polyvinyl chloride (PVC) covers cause less postsurgical adhesion and inflammation than surgical compresses in an animal model. Methods: Female Wistar albino rats (n = 160) were divided into three groups (compress, PVC cover and control), which were then divided into 16 subgroups (n = 10/group). All animals underwent midline laparotomy and cecal abrasion. A metal retractor, which applies a constant force, was then placed on the small intestine for 2 h. In the control group, no material was placed under the retractor, whereas a surgical compress or PVC cover was placed in the experimental animals. Full-thickness small intestinal biopsies were obtained and examined by light and electron microscopy. The following parameters were evaluated: congestion, mesothelial proliferation, leukocyte migration and collagenization. Adhesions were scored according to the Nair, Knightly and Mazuji scoring systems. Results: All inflammation scores were significantly higher in the compress group than in the other two groups. However, no significant difference was observed between the PVC cover and control groups. Adhesions were more frequent in the compress group than in the other two groups, regardless of the scoring system used. Conclusions: Surgical compresses used in abdominal and pelvic surgeries cause inflammation and adhesion. Contrary to surgical compresses, PVC covers do not cause inflammation and adhesion, which may considerably reduce adhesion-related complications in abdominopelvic surgeries.