PREVENTION OF POSTOPERATIVE ABDOMINAL ADHESIONS BY TISSUE PRECOATING WITH POLYMER-SOLUTIONS

Polyvinylpyrrolidone (PVP) and carboxymethylcellulose (CMC) solutions were evaluated in a rat cecal abrasion model to test the effect of these high- molecular-weight hydrophilic polymer solutions on postoperative adhesion formation when used as tissue precoating solutions. Eleven groups of 5-20 animals each were studied including 25 control animals treated with Ringer’s lactate (RL) solution. Animals were reoperated at 2 weeks and adhesions were scored according to a 0-4 grading scale. Tissue coating following cecal abrasion failed to inhibit adhesion formation. However, tissue coating with polymer solutions prior to cecal abrasion significantly reduced the formation of postoperative adhesions. Solutions of 1.5% CMC and 5% of a unique γ- polymerized PVP in RL exhibited the greatest tissue-protective behavior compared to RL controls (P < 0.002). Both CMC and γ-PVP solutions warrant further investigation as tissue precoatings to inhibit surgical adhesions. © 1993 Academic Press, Inc.