eniyu as adhesive intestinal obstasction. In the pathogenesis of postoperative adhesive process
occupies a special place drying
peritoneal cover internal organs and abdominal wall.
Aim of this study was to examine ways of preventing the drying of the peritoneum in
during abdominal operations.
To determine criteria The intensity and prevalence of adhesions
of the mathematical modeling of the phenomenon and propose a method
assess severity of adhesions by the semantic differential.
In the first stage in an acute experiment under ether anesthesia 10 rats Wistar
made eventeratsiya clover in laparotomic injury, and investigated the time
drying intact visceral peritoneum, the peritoneum, covered with a damp cloth,
peritoneum treated 1% methylcellulose gel. In the first case it was 6,4 ±
0,5 min, in the second 18,7 ± 3,6 min, and the third 53,0 ± 4,1 min. And, after
visually identify dry gel in the third case, the film is formed,
peritoneum protects from further drying.
The second stage, three series of rats (10 animals in each series) was performed
median laparotomy. In laparatomnuyu eliminated, the wound site intestine length of 10
cm, 2 cm away from the pyloass. The intestinal loop was kept in the open air
operating for 30 minutes. In the first series produced only
drying loop (control). In the second - eventerirovanny plot bowel
wrapped sterile gauze soaked in physiological saline.
In the third series eventerirovannaya bowel loops were treated with 1% methylcellulose gel
and also was kept in the open air for 30 minutes.
After reposition colon into the abdominal cavity, the latter were sutured tightly.
Lethal outcomes during and after surgery in any of the episodes were not observed.
Animals were removed from the experiment after 14 days by an overdose of ether anesthesia
. Severity of adhesions was evaluated visually (
dissemination process, the deformation of organs, flatulence, presence of effusion in the abdominal cavity
) and using the method of semantic differential (on a five-point scale
with allowance for the significance of each indicator). Produced
photographing the object under study. Abdominal organs and abdominal wall, and
as individual spikes, were subjected to histological examination by standard technique
filled preparations were embedded in paraffin, stain
sections with hematoxylin-eosin and Van Gieson-(Pikra-fuchsin). The data obtained
processed statistically.
Expression saechnogo process (a method of semantic differential) in the first
series was 3,88 ± 0,21 points, the second series of 1,8 ± 0,61 points, and the third
0,09 ± 0,02 points. General condition of animals, figures
clinical analysis of blood indices of leukocyte counts in all series were within the normal
reaction and no statistically significant differences in these parameters between control and experimental groups
we have not noted. Histological examination revealed a decrease
as proliferative and infiltrative processes of
first series of the third, a reduction of infiltration by both histiocytes and fibroblasts
, and by polymorphonuclear leukocytes and lymphocytes;
fewer "young" connective tissue fibers in slices,
prepared from total preparations celiac complexes bodies,
involved in the adhesive process and separate adhesions.
The results show a significant protective effect of methylcellulose gel
for peritoneal cover from drying out.
Thus, the proposed method of preventing intraoperative drying
peritoneum allows to significantly reduce the intensity of postoperative adhesions
and complications associated with the development of
adhesive disease.