J.Jpn. Surg. Soc.. 58(4): 579-594, 1957
EFFECT OF LOCAL USE OF ANTIBIOTICS ON PERITONEAL ADHESIONS EXPERIMENTAL STUDIES
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Surgical Department, Keio University School of Medicine (Director: Prof. Nobukatsu SHIMADA) Toshikazu YOSHIDA |
Macroscopic and microscopic changes were examined when these antibiotics were used intraperitoneally.
In another series of xperiment, 5 cc of 40% glucose solution, 10.000 or 20.000 units of trypsin (TRYPSILIN,TL), 5 cc of 50% urea solution, 5 cc of 0.1% Nitromin solution (nitrogen mustard N-oxide, NM), 2500 units of carzinophilin (CZP) or 10 mg of hydrocortisone acetate (HCA) were injected into the peritoneal cavity through a polyethylene tube after laparotomy for the prevention of adhesion.
The area of adhesion was measured with planimeter after dissection.
1) As mechanical irritation, rubbing of the coecal surface with gauze, cotton or rubber glove was used.
Results : Gauze or cotton glove always produced membranous adhesion. Rubber glove occasionally produced slight adhesion.
2) Blood from the same animal injected into peritoneal cavity made no adhesion.
3) Injection of PC after rubbing the peritoneum with cotton or rubber glove:
10.000u/cc PC 3 cc showed much more adhesions than 1.000 u/cc, especially when the cotton glove was used for rubbing.
4) No change was produced by changing pH of the solution.
After the foregoing preliminary experiment, effects of the same factors were studied in connection with induced peritonits.
5) Groups of animal with intraperitoneal antibiotics generally showed less adhesions than the control (no antibiotics) .
The adhesion vyas least when 1.000 u/cc PC 10 cc was injected into the abdominal cavity, and 0.2g (2 cc) SM solution produced relatively slight adhesion, but 0.5g CM powder, 0.2g (2cc) CM solution, 10% of CM-topical and PSP produced massive adhesions.
6) Injection of 50.000 u. of TL solution almost completely eliminated adhesions in experimental peritonits while 20.000 u. of TL solution did not affect of the production of adhesions. But the former group of cases almost died of extensive petechial hemorrhage of the large intestine.
7) The area of adhesion was reduced to half of the control when 10.000- 20.000 u. of TL solution, 0.1% NM solution, CZP 2.500 u. or HCA 10 mg was used after mechanical irritation of the coecal surface, without peritonits, but 40% glucose and 50% urea solution did not reduce the area of adhesion under the same condition.
(author's abstract)
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