The influence of peritoneal closure on formation of intraperitoneal adhesions: an experimental study.

Adhesion formation to the peritoneal scar was investigated in 108 white Wistar rats which had undergone midline laparotomy under ether anaesthesia. In 92 rats a microtrauma was produced by rubbing the intraperitoneal organs with dry gauze. After this procedure in 46 rats the abdominal cavity was closed by suturing the peritoneum and fascia, and in another 46 rats the peritoneum was left untouched. In the remaining 16 rats a sham operation was performed. The rats were sacrificed after 7, 14, 30 and 60 days and adhesion formation to the peritoneal scar was studied microscopically and macroscopically. It was found that in rats in which the peritoneum layer was sutured a significantly higher amount of adhesion to scar developed. The results of the sham operation proved that the method of abdominal-wall closure is responsible for the adhesion formation to scar after laparotomy.