Postoperative Intraperitoneal Adhesions: A Double-Blind Assessment of their Prevention in the Monkey

Abstract

The effect of combined antihistamine and corticosteroid therapy and the effect of dextran on recurrent intraperitoneal adhesion formation were evaluated in 43 monkeys, all of which had been previously used for reproductive tract studies, and, hence, were suffering from adhesion formation to some degree. In a double-blind manner, the monkeys were randomly divided into 3 experimental groups. 1 group received saline injections before and after lysis surgery followed by introduction of saline solution in the peritoneum during surgery. Group 2 was treated with saline injections, as Group 1, except that dextran solution was introduced into the peritoneal cavity. In Group 3, a combined dexamethasone/promethazine therapy was administered before, during, and after surgery. In all of these monkeys, the degree of adhesion reformation after adhesion lysis surgery was essentially the same in all 3 groups. Rather, careful surgical technique was vastly more important than use of corticosteroids or antihistamines as prophylactic measures.