Abstract
Hydrous magnesium silicate (talc) powder was used inside the pericardial sac to produce adhesions of the pericardium to the epicardium. The reaction consisted in the development of a bread and butter pericarditis without the formation of fluid.
Adhesions occurred between the 2 surfaces as early as 18 hours. After one week the 2 surfaces were firmly adherent, and after 4 weeks the pericardium and the epicardium were fused as one layer of tissue.
There was no widespread development of adhesions beyond the area of the powder, the adhesions forming only at the site of the powder. The talc remained within the pericardial sac in situ and at autopsy was not discovered in the regional lymph glands.
The presence of new blood vessels between the pericardium and the epicardium was demonstrated at subsequent operations when bleeding was observed from both tissues when the 2 layers were separated. Also microscopic sections demonstrated the presence of new blood vessels.
In this series of experiments 46 operations were performed on 40 dogs. Under intraperitoneal nembutal anesthesia and intratracheal oxygen insufflation the chest was opened in the 5th interspace. The lung was manually compressed and held out of the way. The pericardium was opened and approximately one dram of the powder was lightly dropped and sprinkled onto the surface of the epicardium. The pericardium was then closed with a continuous suture. The lung was reëxpanded and the chest closed by percostal sutures and approximation of the soft tissues of the chest wall.
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