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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 2002  |  Volume : 7  |  Issue : 1  |  Page : 15-10

Prevention of Postoperative Intraperitoneal adhesions-an experimental study in rats.


Dept. of Pediatric Surgery, Christian Medical College Ludhiana

Correspondence Address:
M Ahuja
Dept. of Pediatric Surgery, Christian Medical College Ludhiana

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Source of Support: None, Conflict of Interest: None


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ABSTRACT: Adhesion formation is considered to be an inevitable result of surgical trauma to peritoneal surfaces of intraperitoneal organs. Liquid paraffin is thought to prevent adhesions by forming a barrier between the apposing tissues. Methylene blue is hypothesized to inhibit the generation of free radicals thus preventing adhesions. The combined effect of the two in preventing adhesions has not been studied before. A total of 60 rats were studied. They were divided into 4 groups of 15 rats each: (i) Control group, (ii) Liquid paraffin group, (iii) Methylene blue group, (iv) Emulsion group. Talcum powder was used as the adhesion forming agent. Each rat was operated upon twice. In the first operation the control solution or experimental chemical was instilled into the peritoneal cavity at laparotomy. The second operation was done after two weeks of the first. At this operation, grading of adhesions was done. In our study, we have noted the deposition of talc and adhesion formation at certain anatomical sites which have not been described before. Severe adhesion formation was noted in the control group. Liquid paraffin reduces the severity and extent of adhesions significantly. The results with methylene blue were not conclusive. The emulsion group also showed a significant reduction of adhesion formation. Severe adhesions were noted in presence of ongoing intraperitoneal infection. To conclude: 1. The presence of liquid paraffin in the peritoneal cavity reduces adhesion formation significantly; 2. Ongoing intraperitoneal infection bars the effect of adhesion preventing agents. Dose and safety of these chemicals in human beings remains to be established.






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