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Original Article
November 1999

Effect of Surgical Adhesion Reduction Devices on the Propagation of Experimental Intra-abdominal Infection

Author Affiliations

From Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (Drs Tzianabos and Onderdonk and Mr Cisneros); and Genzyme Corp, Cambridge, Mass (Drs Miller and Burns, Ms Gershkovich, and Mr Johnson). Dr Tzianabos and Dr Onderdonk do not hold an equity position in Genzyme Corp, but do serve as consultants. Ms Gershkovich, Mr Johnson, and Drs Miller and Burns are all employees of Genzyme Corp.

Arch Surg. 1999;134(11):1254-1259. doi:10.1001/archsurg.134.11.1254

Hypothesis  The use of certain surgical adhesion reduction devices where there is a risk of concomitant bacterial contamination potentiates intra-abdominal infection.

Design  Evaluation of adhesion reduction devices in an experimental model of intra-abdominal infection.

Setting  Experimental animal model.

Interventions  Adhesion reduction devices were administered at the time of bacterial challenge.

Main Outcome Measures  Animal mortality rate, abscess formation, and bacterial counts in peritoneal fluid and blood cultures.

Results  The use of bioresorbable membrane adhesion reduction devices in the presence or absence of antibiotic therapy did not alter the disease process as compared with appropriate control groups. However, adhesion reduction gels prepared from sodium hyaluronate and carboxymethylcellulose chemically modified with carbodiimide or ferric ion complexed sodium hyaluronate increased the incidence of peritonitis in treated animals. Gel formulations containing diimide-modified carboxymethylcellulose did not have this effect.

Conclusions  The use of certain adhesion reduction devices resulted in the propagation of intra-abdominal infection in an experimental rat model. This outcome was dependent on the composition of the device employed. The use of adhesion reduction devices should be tested in appropriate models of infection where there is the risk of concomitant bacterial contamination.