Peritoneal adhesions: prevention with the use of hydrophilic polymer coatings
E. P. Goldberg, J. W. Sheets and M. B. Habal
Postoperative adhesions, especially peritoneal adhesions, pose an
increasingly serious surgical problem. Modern surgical studies have
generally attempted to deal with the problem after extensive surgical
tissue damage has already occurred. This report focuses on our preliminary
findings from exploratory laparotomies with canine and rat animal models,
which suggest (1) that inadvertent and generally unappreciated serosal
trauma may occur by contact adhesion as well as abrasion and drying
mechanisms and (2) that hydrophilic polymer coatings, such as providone
(polyvinylpyrrolidone), may be effective in protecting the peritoneal
surface from damage. This opens up an important new approach to dealing
with the problem: application of adhesive and lubricating tissue and
surgical material coatings prior to surgical manipulations to limit tissue
damage and thereby minimize postoperative complications. The implications
of this study to many other surgical procedures may also be of considerable
consequence.
