The effectiveness of systemic antibiotics in preventing postoperative, intraabdominal adhesions in an animal model

Objective. Postoperative intraabdominal adhesions can be prevented by antib iotic lavage. We assessed whether systemic antibiotics could prevent adhesi on formation in a rat model. Methods. Cecal abrasion was performed in the peritoneal cavities of 40 Wist ar albino rats. Twenty rats were treated with a 5-day course of cefepim and metronidazole; the remaining animals were given saline injections. The ani mals were sacrificed 14 days after surgery. Adhesion severity scores and hi stopathologic findings were compared. Results. The median adhesion severity score was 2 (0-3) in the antibiotic g roup and 2.5 (1-4) in the controls (P = 0.03). In tissue specimens from con trols, the adhesions were marked by mature collagen bundles. In treated rat s, the adhesions were immature, characterized by early inflammatory cells, less collagen formation, and no collagen bundles. Conclusion. Postoperative systemic antibiotics slow adhesion formation and reduce the severity of the adhesions. (C) 2001 Academic Press.