Murat Api1, Muzaffer Seyhan Cikman2, Aysen Boza1, Murat Bulent Rabus3, Mine Onenerk4, Figen Vardar Aker4. 1. Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. 2. Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. Electronic address: muzaffer124@yahoo.com. 3. Department of Cardiovascular Surgery, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. 4. Department of Pathology, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Goztepe Training and Research Hospital, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Abstract
STUDY OBJECTIVE: To compare adhesion formation and histological features of peritoneal closure and nonclosure over an intra-abdominally placed barbed suture. DESIGN: Single-blind randomized controlled trial (Canadian Task Force Classification I). SETTING: Certified animal research facility. SUBJECTS: Eight nonpregnant rats. INTERVENTIONS: Abdominal cavities were entered via midline incision. Left and right parietal peritoneal surfaces were incised 1.5 cm long separately and stitched with unidirectional barbed suture material (3/0 V-Loc). The parietal peritoneum was approximated over the barbed suture using polypropylene suture material (7/0 Prolene) to embed the barbed suture (peritonization) on one side, and left open on the other side. The side of the barbed suture to be peritonized was allocated at random. On the postoperative day 32, all rats were sacrificed, adhesion formations on each side were macroscopically scored, and histological features were evaluated microscopically. MEASUREMENT AND MAIN RESULTS: The median adhesion score was 2.00 (range, 1-4) on operative fields. There was no statistically significant difference in median adhesion score between the peritonized and nonperitonized sides (1.5 vs 2, respectively; p = .13). Microscopically, there were no statistically significant differences in median acute and chronic inflammation scores between the peritonized and nonperitonized sides (p = .58 and p = .45, respectively), but a significantly higher median fibrosis score on the peritonized side (3 vs 1.5, respectively; p = .02). CONCLUSION: Based on the results of the present study in a rat model, barbed suture material might be associated with adhesion formation when used intra-abdominally, and these adhesions could not be prevented by peritonization.
STUDY OBJECTIVE: To compare adhesion formation and histological features of peritoneal closure and nonclosure over an intra-abdominally placed barbed suture. DESIGN: Single-blind randomized controlled trial (Canadian Task Force Classification I). SETTING: Certified animal research facility. SUBJECTS: Eight nonpregnant rats. INTERVENTIONS: Abdominal cavities were entered via midline incision. Left and right parietal peritoneal surfaces were incised 1.5 cm long separately and stitched with unidirectional barbed suture material (3/0 V-Loc). The parietal peritoneum was approximated over the barbed suture using polypropylene suture material (7/0 Prolene) to embed the barbed suture (peritonization) on one side, and left open on the other side. The side of the barbed suture to be peritonized was allocated at random. On the postoperative day 32, all rats were sacrificed, adhesion formations on each side were macroscopically scored, and histological features were evaluated microscopically. MEASUREMENT AND MAIN RESULTS: The median adhesion score was 2.00 (range, 1-4) on operative fields. There was no statistically significant difference in median adhesion score between the peritonized and nonperitonized sides (1.5 vs 2, respectively; p = .13). Microscopically, there were no statistically significant differences in median acute and chronic inflammation scores between the peritonized and nonperitonized sides (p = .58 and p = .45, respectively), but a significantly higher median fibrosis score on the peritonized side (3 vs 1.5, respectively; p = .02). CONCLUSION: Based on the results of the present study in a rat model, barbed suture material might be associated with adhesion formation when used intra-abdominally, and these adhesions could not be prevented by peritonization.