Numerous investigators have used various drugs in attempts to prevent postoperative adhesions, but without success. Among the agents tested have been amniotic fluid, sodium ricinoleate, hypertonic glucose, proteolytic enzymes, heparin and bishydroxycoumarin (dicumarol®).
The initial stage in the formation of scar tissue is the local deposit of fibrin plus a considerable amount of gelatinous nucleoprotein. Wright1 and his associates of the Department of Surgery, Harlem Hospital, New York, therefore thought that success might follow the use of a mixture of fibrinolysin and nucleoproteinase. Previous investigators2 had shown that broth cultures of certain strains of hemolytic streptococci form both a fibrinolytic principle ("streptokinase") and a nucleoproteinase ("streptodornase"). When streptococcic concentrate is added to inflammatory exudate, a rapid lysis of both fibrin and nucleoprotein occurs. The Harlem surgeons therefore tested the effects of commercial streptococcic metabolites on postoperative adhesions.
Fifty adult male rabbits were used in these tests, equally divided
PREVENTION OF POSTOPERATIVE ADHESIONS. JAMA. 1951;145(15):1138. doi:10.1001/jama.1951.02920330028015
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