Abstract
The problem of postoperative adhesions remains unsolved. The formation of readhesions after tubal reconstructive surgery reduces the success rate. We have developed a modified uterine horn model in the rat to study the influence of peritoneal transplants on readhesion formation. A total of 58 rats were operated. In 25 animals (group III) the uterine horn was scratched on both sides and then sutured together. During relaparotomy 14 days later the tight connection between both sides was cut. The resulting defect was covered by a peritoneal transplant on one side (group IIIb) and was left open on the control side (group IIIa). After I4 days the presence or absence of adhesions was explored. There was a significant difference (p <. 001) between the covered (28%) and uncovered (84%) peritoneal defects with respect to incidence of adhesions. To compare the different characteristics of visceral and parietal peritoneum, a pelvic sidewall defect was induced in 33 animals. There was no significant difference between covering the defect by a peritoneal transplant (group II; 42.9%) and the control side (group I; 33.3%). These data suggest that defects on visceral peritoneum should be closed to prevent adhesion formation. The incidence of adhesions after injury of parietal peritoneum seems to be much lower and of less clinical significance.