Experimental evaluation of phospholipids and icodextrin in re-formation of peritoneal adhesions

Abstract

Abstract Background The formation of further adhesions after adhesiolysis is a major problem. Not all agents that are supposed to reduce de novo adhesions can reduce further adhesion formation. The efficacy and safety of intraperitoneally applied phospholipids has been shown previously. This study evaluated the influence of phospholipids and icodextrin on adhesion re-formation. Methods In an experimental study on 60 Chinchilla rabbits adhesions were induced by standardized abrasion of defined areas of the ventral abdominal wall, the caecum and the ileum. Open adhesiolysis was performed 10 days later. The animals randomly received either 1·5 per cent phospholipids, 4 per cent icodextrin or Ringer's lactate intraperitoneally. Half of the animals in each group were killed after a further 10 days and the remainder at 20 days. Adhesion formation was assessed by computer-aided planimetry and histopathological examination. Results Phospholipids (10 days: P = 0·001; 20 days: P = 0·012) and icodextrin (10 days: P = 0·006; 20 days: P = 0·055) reduced adhesion re-formation after both intervals compared with Ringer's lactate controls. Conclusion Phospholipids and icodextrin were effective in preventing re-formation of adhesions.