Glove powder promotes adhesion formation and facilitates tumour cell adhesion and growth

Background: The presence of foreign material in the abdominal cavity irrita tes the peritoneal surface, leading to an inflammatory response. This defen sive mechanism can provoke adhesion formation. The same peritoneal defence cascade is thought to play a role in the process of intra-abdominal tumour recurrence. The aim of this study was to evaluate whether glove powder prod uced peritoneal adhesions in a rat adhesion model and whether it promoted i ntra-abdominal turnout recurrence in a rat turnout cell adhesion and growth model. Methods: A reproducible model that allowed semiquantitative scoring of adhe sion formation or tumour load was used in three different groups of rats. O ne group was treated by intra-abdominal application of powder obtained from starch-powdered gloves, one by application of pure starch and in one group no powder was used. Results: Application of glove powder or pure starch on minimally and severe ly traumatized peritoneum gave rise to significantly greater adhesion forma tion and intra-abdominal tumour load than peritoneal trauma alone (both P < 0.001). Conclusion: Starch-induced peritoneal trauma leads not only to more adhesio n formation but also to increased adhesion and growth of tumour cells. Sinc e good powder-free alternatives are available there is no longer any justif ication for the use of powdered gloves during intra-abdominal surgery.