Postoperative exposure to glove powders modulates production of peritonealeicosanoids during peritoneal wound healing

Objective: To assess the effect of postsurgical exposure of peritoneal cavi ty to glove powders, Hydrocote, latex proteins, and lipopolysaccharide (LPS ) on eicosanoid production in peritoneal fluid and cellular distribution of eicosanoid enzymes in peritoneal wound during healing. Design: Randomised experimental study. Setting: Institute for Wound Research, USA. Animals: 360 mice randomised into six groups of 60 each. Intervention: Abrasion of peritoneal cavity followed by instillation of 500 mu l of sterile phosphate buffered saline (PBS) alone (Control) or contain ing 100 mu g/ml of Biosorb, Keoflo, Hydrocote, 1 mg/ml of latex proteins, o r 12.5 mu g/ml of LPS. Mice were killed at 1, 2, 4, 7, 14 and 28 days, and the peritoneal washing obtained from each animal and concentration of eicos anoids measured. Tissue were immunostained for cyclooxygenases and 5-lipoxy genase and thromboxane A(2) (TXA(2)) synthetase. Results: Peritoneal fluid from uninjured controls contained 3.9 (0.8), 512 (0.3) and 0.2 (0.02) ng/ml of thromboxane B-2 (TXB2), prostaglandin E-2 (PG E(2)) and leukotriene B-4 (LTB4), respectively. These increased significant ly during the first week to 6.3 (0.3), 11.7(0.8) and 2.6 (0.1) ng/ml, p < 0 .05, before returning to baseline by day 14. In all the treated groups the values were significantly higher than in controls (p < 0.05). Imunoreactive cyclo-oxygenases, 5-lipoxygenase and TXA2 synthetase proteins were present in various cell types in uninjured skin and peritoneum, incisional and per itoneal wounds and adhesion tissues. Staining was more intense at the site of wounds and paralleled eicosanoid concentrations during healing. There wa s no difference between exposed and unexposed groups. Conclusion: The presence of glove powders, latex proteins and LPS in perito neal cavity cause increased eicosanoid production and aggravate the normal inflammatory reaction to tissue injury. This may contribute to the inflamma tory or immune reactions and development of adhesions caused by glove powde rs.