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 post-operative adhesions. Solutions of 1.5% CMC and 5% of a unique gamma-polymerized PVP in RL exhibited the greatest tissue-protective behavior compared to RL controls (P < 0.002). Both CMC and gamma-PVP solutions warrant further investigation as tissue precoatings to inhibit surgical adhesions.