Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E and human amniotic membrane

Background: Our objective was to evaluate the comparative effectiveness of intraperitoneally administered vitamin E and human amniotic membrane in preventing postoperative intraperitoneal adhesion formation. Material and Methods: 75 Wistar-albino rats were separated into 5 groups: Group 1 (control), Group 2 (intraperitoneal olive oil, the diluent of vitamin E), Group 3 (Intraperitoneal vitamin E diluted in olive oil), Group 4 (Amniotic membrane group) and Group 5 (Amniotic membrane and Intraperitoneal vitamin E diluted in olive oil). The same experimental method, consisting of cecal abrasion and ligature of the adjacent parietal peritoneum, was used in all rats to produce adhesions. Relaparotomy was performed on the 15th postoperative day. intra-abdominal adhesions were scored according to macromorphological characteristics and adhesion-carrying tissues underwent standard histologic examination. Inflammation, vascularization and fibrosis in granulation sites were graded in all samples. The results were analyzed using a Mann-Whitney-U test. Results: In terms of inflammation, neovascularization and fibrosis scores obtained by histology and macromorphologic adhesion scores. There were no significant differences between Groups 1 and 2 (p = 0.176). The results of Groups 3, 4 and 5 showed a significant difference when compared with both Group 1 and 2 (p = 0.001). The difference between Groups 3, 4 and 5 were not significant with respect to these 4 parameters. Conclusion: Intraperitoneal vitamin E and amniotic membrane treatment were both effective in the prevention of peritoneal adhesions. The combination of these agents did not produce a synergistic effect. Easy applicability of the intraperitoneal administration of vitamin E was its major advantage. (C) 2009 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.