Collagen-PVP, a collagen synthesis modulator, decreases intraperitoneal adhesions

Background. Adhesion formation in the peritoneal cavity is the most common cause of intestinal obstruction and secondary female infertility. A great effort has been dedicated to reduce adhesion formation because of the associated morbidity and its complications. Materials and methods. This study was designed as a before-after comparative trial and included 14 rabbits, with a weight between 300 and 500 g. All rabbits were appendectomized and 1 month later laparotomized to assess adhesion formation. Rabbits were randomized into two groups, Group I (control group), with no intervention, and Group II (experimental group), treated with an intraperitoneal sponge of collagen-polyvinylpyrrolidone (Clg-PVP). The laparotomy procedure was repeated 1 month later for a new assessment of adhesion formation and histological evaluation by H-E and Masson staining. Results. Histological findings showed abundant infiltrate in the control group, which was mild in the experimental group. With the Masson stain the control group showed a significantly higher amount of collagen than the experimental group and the fibrous tissue was more compact. We found a mean number of adhesions of 3.29 +/- 1.98 for the control group, which decreased to 2.57 +/- 0.79 after the second laparotomy. For the experimental group the mean number of adhesions decreased from 1.86 +/- 0.90 to 0.71 +/- 0.49 after the second laparotomy, with no statistical difference between both groups before Clg-PV-P application, but a significant statistical difference after the implantation of Clg-PVP (Student's t test; P < 0.001, two-tailed). Conclusion. Collagen-polyvinylpyrrolidone decreases the incidence and size of intraabdominal adhesions after secondary adhesion formation after appendectomy. (C) 2003 Elsevier Science (USA).