Prevention of peritoneal adhesions by silicone solution.

Abstract

THE DIFFERENT mechanisms of postoperative peritoneal adhesion formation have been elucidated. However, the prevention of these adhesions still presents a major problem. The methods that may be considered in prevention of postoperative adhesions may be classified into five different groups. 1. Peritonealization: covering all raw surfaces by peritoneum, omental, or amniotic membrane grafts.^1,2 2. Mechanical separation of raw surfaces. This may be achieved in several ways. (a) Activation of early peristalsis by pharmacological (prostigmin) or mechanical methods (heat, diathermia, etc).^3,4 (b) Introduction into peritoneal cavity of substances that will keep operative surfaces separated. This includes the introduction of isotonic solutions, amniotic fluid, macromolecular dextran, lubricants like polyvinylpyrolidone, and others^1,5-10(an unpublished data). 3. Anticoagulants applied locally.¹¹ 4. Fibrinolytic or proteolytic enzymes like streptokinase and streptodornase.^11-14 5. Inhibition of connective tissue formation by corticoids applied locally or given systemically.^14,15 Some of these methods have proved