Abstract
To investigate the effects of chlorhexidine on the formation of adhesions and dilation of the colon at the oral end of anastomosis in the presence of peritonitis. Peritonitis was induced in male Wistar rats by cecal ligation and puncture (CLP). Abdominal cavities were irrigated with tepid solutions containing 0.9% saline (SAL group; n=8) or 0.05% chlorhexidine (CHD group; n=8), after which colon anastomoses were performed. Control rats (n=8) were submitted to colon anastomoses but not to CLP. Animals were euthanised seven days after surgery and the incidence of adhesions, the degree of dilation of colon loops and an index were calculated to determine variables correlation. No animals exhibited macroscopic signs of residual peritonitis or abdominal abscesses. Adhesions were observed in 75% of control and 100% of SAL and CHD animals. Dilation of intestinal loops at the oral end of anastomosis was observed in control (50%), SAL (57.2%) and CHD (66.7%) animals. The calculated index was 1.25 in group A; 1.86 in group B; and 2.0 group C. Chlorhexidine promoted stronger adhesions and a greater dilatation of colonic loops than control group.
Highlights
MethodsThe formation of peritoneal adhesions represents part of the anatomical and functional repair processes that occur following a chemical, physical or biological injury[1,2]
There were no statistical differences between the mean numbers of adhesions present in animals of the control group and those of the saline-treatment group (SAL) group or of the chlorhexidine-treatment group (CHD) group
No grade III adhesions were observed in animals of the SAL and CHD groups, 85.7% of individuals of the SAL group and 100% of those of the CHD group presented grade II adhesions
Summary
The formation of peritoneal adhesions represents part of the anatomical and functional repair processes that occur following a chemical, physical or biological injury[1,2] Such adhesions are produced by the deposition of fibrin during the initial stages of inflammation of the abdominal cavity when the organism is trying to restore homeostasis[3,4]. This type of complication is intrinsic to surgical procedures, it may occur as a consequence of other inflammatory processes and can evolve into more severe conditions including intestinal obstruction and chronic abdominal pain. Most published indexes are based on the number of fibrotic strands formed, the extension of the contact area between the structures and the strength required to separate them[3,9,10,11,12,13,14]
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