EXPERIMENTAL ADHESION PROPHYLAXIS WITH RECOMBINANT TISSUE-PLASMINOGENACTIVATOR

The deposition of fibrin in the peritoneal cavity leads to fibrous adh esion formation. Recombinant tissue plasminogen activator (rtPA), deli vered locally, was investigated as a method of preventing adhesion for mation. Six standardised areas of peritoneal ischaemia were formed in each of 36 male Wistar rats randomised to three intraperitoneal treatm ents: (A) no treatment control; (B) carboxymethylcellulose gel; (C) rt PA-carboxymethylcellulose gel combination. At 1 week all animals under went relaparotomy and the number of ischaemic sites with an adhesion c ounted by an independent observer. rtPA-treated animals formed fewer a dhesions compared with gel alone or controls (median number of adhesio ns 1.5 versus 2.5 versus 5, P < 0.001, ANOVA). Intraperitoneal rtPA in a slow-release formulation is able to reduce adhesion formation signi ficantly in an animal model and may prove to have clinical benefit.