Efficacy of adhesion prevention and impact on wound healing of intraperitoneal phospholipids

Background. Postoperative peritoneal adhesions are a major complication of abdominal surgery. Adjuvant therapy is needed to prevent adhesion formation and subsequent sequelae. Previously published data proved the efficacy of phospholipids (PL) for this indication; however, additional information on drug safety was still outstanding. The underlying study was designed to inv estigate the influence of phospholipids on three different types of healing tissue. Materials and methods. A total of 48 Chinchilla rabbits underwent median la parotomy, standardized abrasion of the visceral and parietal peritoneum, je junal anastomosis, and an electrocautery incision of the liver. The operati on was completed by intraperitoneal administration of 10 ml/kg of either no rmal saline (NaCl) or phospholipids (12%). Results. After 5 (NaCl 691 mm(2) vs PL 192 mm(2)) and 10 days (NaCl 625 mm( 2) vs PL 88 mm(2)) the control group presented with significantly larger ad hesion areas (P < 0.05). The bursting pressure of the anastomosis on the 5t h (NaCl 16.1 kPa vs PL 18.2 kPa) and 10th (NaCl 19.7 kPa vs PL 18.6 kPa) po stoperative days showed no statistically significant difference. The tensil e strength of the laparotomy wound measured after intervals of 5 (NaCl 8.5 N cm(-1) vs PL 6.8 N cm(-1)) and 10 days (NaCl 23.0 N cm(-1) vs PL 20.2 N c m(-1)) was not statistically different either. The collagen protein ratio o f anastomoses, laparotomy wounds, and liver incisions as well as the inflam matory-reparative response of the different tissues was not affected by FL. Conclusions. These results confirm the efficacy of phospholipids in adhesio n prevention. The findings of uncompromized healing of anastomoses, laparot omy wounds, and liver incisions demonstrate the safety of this agent. Furth er data may qualify phospholipids for a clinical trial, (C) 2001 Academic P ress.