Skip to main content
SpringerLink
Log in

Effects of Peritoneal Lavage with Scolicidal Agents on Survival and Adhesion Formation in Rats

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Intraoperative irrigation of the peritoneal cavity with scolicidal agents is frequently recommended when dealing with traumatic or spontaneous rupture of hydatid cysts. The present experimental study was designed to examine the influence of various scolicidal agents on adhesion formation and survival. A total of 149 rats were randomly allocated to nine groups. Peritoneal lavage through a median laparotomy was performed with the following scolicidal agents. Group 1 (0.9% saline: controls), group 2 (20% hypertonic saline), group 3 (0.04% chlorhexidine gluconate), group 4 (3% hydrogen peroxide), group 5 (0.5% silver nitrate), group 6 (1% polyvinylpyrrolidone-iodine, or PVP-I ), group 7 (5% PVP-I), group 8 (0.5% cetrimide/0.05% chlorhexidine), and group 9 (10% PVP-I). The surviving animals were sacrificed on postoperative day 15. Adhesion formation was macroscopically graded by the Nair criteria. The severity of adhesion formation was evaluated microscopically using the fibrosing scoring criteria and the strain test. Group 9 (10% PVP-I) was excluded from the adhesion evaluation because all of the rats died in this group. The mortality rate was significantly higher in groups 5 and 7 than in groups 1, 2, 3, 4, 6, and 8. Adhesion scores were significantly lower in groups 1, 2, 3, and 4 than in groups 5, 6, 7, and 8. The lowest adhesion score was found in group 3 and the highest in the group 7. These results indicate that 0.04% chlorhexidine gluconate, the most potent scolicidal agent in vitro and in vivo, was associated with the lowest adhesion formation and mortality among various scolicidal agents in this experimental study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ellis H, Moran BJ, Thampson JN, et al. Adhesion related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet 1999;353:1476–1480

    PubMed  CAS  Google Scholar 

  2. De Cherney AH, Dizerega GS. Clinical problem of peritoneal adhesion formation following general surgery and use of adhesion prevention barriers. Clin North Am 1997;77:671–688

    Google Scholar 

  3. diZerega GS. Use of adhesion prevention barriers in ovarian surgery, tubalplasty, ectopic pregnancy, endometriosis, adhesiolysis, and myomectomy. Curr Opin Obstet Gynecol 1996;8:230–237

    PubMed  CAS  Google Scholar 

  4. Ray NF, William G, Denton RN, et al. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 1998;186:1–9

    Article  PubMed  CAS  Google Scholar 

  5. Taylor DH, Morris DL. The current management of hydatid disease. Br J Clin Pract 1988;42:401–406

    PubMed  CAS  Google Scholar 

  6. Langer B. Surgical treatment of hydatid disease of the liver. Br J Surg 1987;74:237–242

    PubMed  CAS  Google Scholar 

  7. Mottaghian H, Saidi F. Postoperative recurrences of hydatid disease. Br J Surg 1978;65:237–242

    PubMed  CAS  Google Scholar 

  8. Cakmakci M, Sayek I. Prophylactic effect of albendazole in experimental peritoneal hydatidosis. Hepatogastroenterology 1992;39:424–426

    PubMed  CAS  Google Scholar 

  9. Nair SK, Bhat KI, Aurora LA. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions. Arch Surg 1974;108:849–853

    PubMed  CAS  Google Scholar 

  10. Erenoglu C, Akın ML, Aydın S, et al. The prophylactic effect of interferon and vitamin E on postoperative peritoneal adhesions (experimental study). Cagdas J Surg 1997;11:195–198

    Google Scholar 

  11. Menzies D, Ellis H. Intestinal obstruction from adhesions: how big is the problem? Ann R Coll Surg Engl. 1990;72:60-63

    PubMed  CAS  Google Scholar 

  12. Ray NF, Larsen JW, Stillman RU, et al. Economic impact of hospitalization for lower abdominal adhesiolysis in the United States in 1988. Surg Gynecol Obstet 1993;176:271

    PubMed  CAS  Google Scholar 

  13. Amir-Jahed AK, Fardin R, Farzad A, et al. Clinical echinococcosis. Ann Surg 1975;182:541–546

    PubMed  CAS  Google Scholar 

  14. Little JM, Holland MJ, Ekberg H. Recurrence of hydatid disease. World J Surg 1988;65:700–704

    Google Scholar 

  15. Barros JL. Hydatid disease of the liver. Am J Surg 1978;135:597–600

    Article  PubMed  CAS  Google Scholar 

  16. Gokce O, Gokce C, Yilmaz M, et al. Povidone-iodine in experimental peritoneal hydatidosis. Br J Surg 1991;78:495–496

    PubMed  CAS  Google Scholar 

  17. Landa Garcia JI, Alonso E, Gonzalez-Uriarte J, et al. Evaluation of scolicidal agents in an experimental hydatid disease model. Eur Surg Res 1997;29:202–208

    PubMed  CAS  Google Scholar 

  18. Puryan K, Karadayi K, Topcu O, et al. Chlorhexidine gluconate: an ideal scolicidal agent in the treatment of intraperitoneal hydatidosis? World J Surg 2005;29:227–230

    Article  PubMed  Google Scholar 

  19. Besim H, Karayalcin K, Hamamci O, et al. Scolicidal agents in hydatid cyst surgery. HPB Surg 1998;10:347–355

    PubMed  CAS  Google Scholar 

  20. LeVeen HH, LeVeen FR, LeVeen EG. The mythology of povidone-iodine and the development of self-sterilizing plastics. Surg Gynecol Obstet 1993;176:183–189

    PubMed  CAS  Google Scholar 

  21. Mazuji MK, Fadhli HA. Peritoneal adhesions. Arch Surg 1965;19:872–874

    Google Scholar 

  22. Badowski A, Daciews Z. The importance of high molecular weight colloid substances in prevention of peritoneal adhesions. Polish Med J 1971;10:147–153

    CAS  Google Scholar 

  23. Janik JS, Nagaraj HS, Groff DB. Prevention of postoperative peritoneal adhesions: efficacy of povidone. Arch Surg 1982;117:1321–1324

    PubMed  CAS  Google Scholar 

  24. Gilmore OJ, Reid C. Prevention of intraperitoneal adhesions: a comparison of noxythiolin and a new povidone-iodine/PVP solution. Br J Surg 1979;66:197–199

    PubMed  CAS  Google Scholar 

  25. Van Westreenen M, van den Tol PM, Pronk A, et al. Perioperative lavage promotes intraperitoneal adhesion in the rat. Eur Surg Res 1999;31:196–201

    PubMed  Google Scholar 

  26. Roberts LM, Sanfilippo JS, Raab S. Effects of laparoscopic lavage on adhesion formation and peritoneum in an animal model of pelvic inflammatory disease. J Am Assoc Gynecol Laparosc 2002;9:503–507

    Article  PubMed  Google Scholar 

  27. Mund-Hoym S, Roberg A. Adhesion prophylaxis-a comparative experimental animal study. Res Exp Med 1982;181:171–180

    Article  Google Scholar 

  28. Meymerian E, Luttermoser GW, Frayha GJ, et al. Host-parasite relationships in echinococcosis. X. Laboratory evaluation of chemıcal scolicides as adjuncts to hydatid surgery. Ann Surg 1963;2:211–215

    Google Scholar 

  29. WHO Informal Working Group on Echinococcosis. Bull WHO 1996;74:231–242

    Google Scholar 

  30. Magistrelli P, Masetti R, Coppola R, et al. Surgical treatment of hydatid disease of the liver: a 20-year experience. Arch Surg 1991;126:518–523

    PubMed  CAS  Google Scholar 

  31. Djilali G, Mahrour A, Oussedik T, et al. Hydrogen peroxide in the surgery of hydatid cyst. Presse Med 1983;12:235–237

    PubMed  CAS  Google Scholar 

  32. Belghiti J, Perniceni T, Kabbej M, et al. Complications of peroperative sterilization of hydatid cysts of the liver: apropos of 6 cases. Chirurgie 1991;117:343–346

    PubMed  CAS  Google Scholar 

  33. Kayaalp C, Balkan M, Aydin C, et al. Hypertonic saline in hydatid disease. World J Surg 2001;25:975–979

    Article  PubMed  CAS  Google Scholar 

  34. Sonisik M, Korkmaz A, Besim H, et al. Efficacy of cetrimide-chlorhexidine combination in surgery for hydatid cyst. Br J Surg 1998;85:1277

    Article  PubMed  CAS  Google Scholar 

  35. Baraka A, Wakid N, Yamout F. Methemoglobinemia during surgical excision of hydatid cyst. Middle East J Anaesthesiol 1980;5:509–513

    PubMed  CAS  Google Scholar 

  36. Momblano P, Pradere B, Jarrige N, et al. Metabolic acidosis induced by cetrimonium bromide. Lancet 1984;2:1045

    PubMed  CAS  Google Scholar 

  37. Gilchrist DS. Chemical peritonitis after cetrimide washout in hydatid-cyst surgery. Lancet 1979;2:1374

    PubMed  CAS  Google Scholar 

  38. Karayalcin K, Besim H, Koyuncu A, et al. Effect of peritoneal lavage with cetrimide-chlorhexidine solution on survival and adhesion formation in rat: an experimental study. T Clin J Med Res 1998;16:26–28

    Google Scholar 

  39. Laufhman H. Current use of skin and wound cleansers and antiseptics. Am J Surg 1989;157:359–365

    Google Scholar 

  40. Platt J, Jones RA, Bucknall RA. Intraperitoneal antiseptics in experimental bacterial peritonitis. Br J Surg 1984;71:626–628

    PubMed  CAS  Google Scholar 

  41. Celdran Uriarte A, Inarrea Lasheras P, Marijuan Martin JL, et al. Effect of povidone iodine and chlorhexidine on the mortality and bacterial clearance in the abdominal cavity of peritonitis rats. Eur J Surg 1991;157:393–395

    PubMed  CAS  Google Scholar 

  42. Vallance S, Waldron R. Antiseptic vs saline lavage in purulent and faecal peritonitis. J Hosp Infect 1985;6:87–91

    PubMed  Google Scholar 

  43. Bondar VM, Rago C, Cottone FJ, et al. Chlorhexidine lavage in the treatment of experimental intra-abdominal infection. Arch Surg 2000;135:309–314

    PubMed  CAS  Google Scholar 

  44. Maleckas A, Daubaras V, Vaitkus V, et al. Increased postoperative peritoneal adhesion formation after the treatment of experimental peritonitis with chlorhexidine, Langenbecks Arch Surg 2004;389:256–260

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Cumhuriyet University, School of Medicine, Sivas, 58140, Turkey

    Omer Topcu MD

  2. Department of Pathology, Ankara University, School of Medicine, Ankara, 06100, Turkey

    Isinsu Kuzu MD

  3. Department of General Surgery, Ankara University, School of Medicine, Ankara, 06100, Turkey

    Kaan Karayalcin MD

Authors
  1. Omer Topcu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Isinsu Kuzu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaan Karayalcin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Omer Topcu MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Topcu, O., Kuzu, I. & Karayalcin, K. Effects of Peritoneal Lavage with Scolicidal Agents on Survival and Adhesion Formation in Rats. World J. Surg. 30, 127–133 (2006). https://doi.org/10.1007/s00268-005-7960-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7960-4

Keywords

Search

Navigation