Collagen-PVP, a collagen synthesis modulator, decreases intraperitoneal adhesions

J Surg Res. 2003 Mar;110(1):207-10. doi: 10.1016/s0022-4804(02)00099-9.

Abstract

Background: Adhesion formation in the peritoneal cavity is the most common cause of intestinal obstruction and secondary female infertility. A great effort has been dedicated to reduce adhesion formation because of the associated morbidity and its complications.

Materials and methods: This study was designed as a before-after comparative trial and included 14 rabbits, with a weight between 300 and 500 g. All rabbits were appendectomized and 1 month later laparotomized to assess adhesion formation. Rabbits were randomized into two groups, Group I (control group), with no intervention, and Group II (experimental group), treated with an intraperitoneal sponge of collagen-polyvinylpyrrolidone (Clg-PVP). The laparotomy procedure was repeated 1 month later for a new assessment of adhesion formation and histological evaluation by H-E and Masson staining.

Results: Histological findings showed abundant infiltrate in the control group, which was mild in the experimental group. With the Masson stain the control group showed a significantly higher amount of collagen than the experimental group and the fibrous tissue was more compact. We found a mean number of adhesions of 3.29 +/- 1.98 for the control group, which decreased to 2.57 +/- 0.79 after the second laparotomy. For the experimental group the mean number of adhesions decreased from 1.86 +/- 0.90 to 0.71 +/- 0.49 after the second laparotomy, with no statistical difference between both groups before Clg-PVP application, but a significant statistical difference after the implantation of Clg-PVP (Student's t test; P < 0.001, two-tailed).

Conclusion: Collagen-polyvinylpyrrolidone decreases the incidence and size of intraabdominal adhesions after secondary adhesion formation after appendectomy.

MeSH terms

  • Animals
  • Appendectomy / adverse effects
  • Collagen / antagonists & inhibitors
  • Collagen / biosynthesis
  • Collagen / therapeutic use*
  • Female
  • Male
  • Peritoneal Diseases / etiology
  • Peritoneal Diseases / pathology
  • Peritoneal Diseases / prevention & control*
  • Peritoneal Diseases / surgery
  • Povidone / therapeutic use*
  • Rabbits
  • Secondary Prevention
  • Tissue Adhesions / etiology
  • Tissue Adhesions / pathology
  • Tissue Adhesions / prevention & control
  • Tissue Adhesions / surgery

Substances

  • collagen-PVP
  • Collagen
  • Povidone