Abstract
Summary
Sodium ricinoleate, 1%, papain 1-50,000, and amfetin and defibrinated rabbit's blood were found most efficacious in obviating adhesion formation after painting the traumatized peritoneal surface with iodine. Sodium ricinoleate would appear to be particularly valuable in that it is not rendered inactive in the presence of infection.
In this study, the following substances were compared with regard to their relative effectiveness in preventing peritoneal adhesions in rabbits: defibrinated ox blood, defibrinated rabbit blood, amniotic fluid, amfetin,∗ sodium ricinoleate (1%), blood serum of dog, ether, hypertonic glucose (10%), normal saline, papain 1–50,000, air, air and sodium ricinoleate (1%), air and amfetin.
The method was as follows: under ether anesthesia, the abdomen of the rabbit was opened and a culture taken with sterile precautions. Intraperitoneal adhesions were produced by roughening the peritoneum and intestines with a knife or rubbing with gauze, and painting the raw surfaces with tincture of iodine. In 12 animals so treated (controls) 2 died from the procedure, and of the 10 surviving 9 developed peritoneal adhesions (90%). Twenty cubic centimeters of the substance to be tested were introduced into the peritoneal cavity after the iodine was applied. When air was also added, 20 cc. of the solution and 60 cc. of the air were used. About 10 rabbits were used in each series. In the 4 best series the effectiveness was studied in another 10 rabbits to make the number of animals used (20) significant. The rabbits were allowed to live one week before being killed, when a culture was again taken. The peritoneal reaction was studied. Adhesions were graded as slight, medium or dense. The results of the experiments are tabulated in Table I.
Results. The 4 substances that were most effective in preventing adhesions in this study were: Sodium ricinoleate (1%), 85%; Papain 1–50,000, 75%; Amfetin, 70%; defibrinated rabbit's blood 65%.
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