AN EXPERIMENTAL-STUDY OF THE EFFECT OF APROTININ ON INTESTINAL ADHESION FORMATION

BACKGROUND: Depression of fibrinolysis is known to be a major mechanis m for postoperative adhesion formation. Because aprotinin inhibits fib rinolysis it may lead to an increase in adhesion formation whereas its anti-inflammatory effects may lead to a decrease in adhesion formatio n. Our aim is to clarify conflicting results in previous literature, M ETHODS: Basal levels of intestinal hydroxyproline (OHP) content and lo cal fibrinolytic activity (LFA) were determined using naive groups. In the experiment groups, adhesions were created by scraping and creatin g a transient ischemia of a segment of terminal ileum, Group I and II rats were injected subcutaneous (sc) normal saline (NS) for 3 days and single dose intraperitoneal (ip) NS, respectively. Group III and IV r ats were injected sc aprotinin for 3 days and single dose ip aprotinin , respectively. Group V rats were injected intramuscular methylprednis olone (MP) for 3 days. LFA and OHP levels were determined on the secon d and fifth postoperative days. The severity of adhesion formation was graded on the fifth day. RESULTS: Aprotinin decreased both the severi ty of adhesions and OHP levels whereas MP decreased only the severity of adhesions, There was an early depression of LFA at the second day i n both NS and MP groups increasing to basal levels at the fifth day. O HP levels showed significant correlation with adhesion severity. CONCL USION: Results showed that aprotinin decreased intra-abdominal adhesio n formation probably by preventing early depression of LFA, (C) 1998 b y Excerpta Medica, Inc.