Effect of surgical adhesion reduction devices on the propagation of experimental intra-abdominal infection

Hypothesis: The use of certain surgical adhesion reduction devices where th ere is a risk of concomitant bacterial contamination potentiates inaa-abdom inal infection. Design: Evaluation of adhesion reduction devices in an experimental model o f intra-abdominal infection. Setting: Experimental animal model. Interventions: Adhesion reduction devices were administered at the time of bacterial challenge. Main Outcome Measures: Animal mortality rate, abscess formation, and bacter ial counts in peritoneal fluid and blood cultures. Results: The use of bior esorbable membrane adhesion reduction devices in the presence or absence of antibiotic therapy did not alter the disease process as compared with appr opriate control groups. However, adhesion reduction gels prepared from sodi um hyaluronate and carboxymethylcellulose chemically modified with carbodii mide or ferric ion complexed sodium hyaluronate increased the incidence of peritonitis in treated animals. Gel formulations containing diimide-modifie d carboxymethylcellulose did not have this effect. Conclusions: The use of certain adhesion reduction devices resulted in the propagation of intra-abdominal infection in an experimental rat model. This outcome was dependent on the composition of the device employed. The use o f adhesion reduction devices should be tested in appropriate models of infe ction where there is the risk of concomitant bacterial contamination.