Clorhexidine as a factor that promotes peritoneal adhesions in rats with induced peritonitis

Abstract

PURPOSE:To investigate the effects of chlorhexidine on the formation of adhesions and dilation of the colon at the oral end of anastomosis in the presence of peritonitis. METHODS:Peritonitis was induced in male Wistar rats by cecal ligation and puncture (CLP). Abdominal cavities were irrigated with tepid solutions containing 0.9% saline (SAL group; n = 8) or 0.05% chlorhexidine (CHD group; n = 8), after which colon anastomoses were performed. Control rats (n = 8) were submitted to colon anastomoses but not to CLP. Animals were euthanised seven days after surgery and the incidence of adhesions, the degree of dilation of colon loops and an index were calculated to determine variables correlation. RESULTS:No animals exhibited macroscopic signs of residual peritonitis or abdominal abscesses. Adhesions were observed in 75% of control and 100% of SAL and CHD animals. Dilation of intestinal loops at the oral end of anastomosis was observed in control (50%), SAL (57.2%) and CHD (66.7%) animals. The calculated index was 1.25 in group A; 1.86 in group B; and 2.0 group C. CONCLUSION:Chlorhexidine promoted stronger adhesions and a greater dilatation of colonic loops than control group.

An evaluation of the effect of ertapenem in rats with sepsis created by cecal ligation and puncture

“…It has been thought that a reduction in bacterial contamination and decreased local and systemic inflammation will result in fewer fibrin deposits and intra-abdominal adhesions. [3] In the present study, there was a high correlation between adhesion score and number of colonies (r=0.539, p=0.003). No statistically significant decrease was found in the number of colonies in any of the antibiotic-treated groups in the current study (p=0.109).…”

“…[2] a decrease in bacterial contamination and inflammation. [3] A previous study evaluated the potential effects of several antibiotics used intra-abdominally, and it was reported that the degree of adhesiveness was lower in the antibiotic-treated groups than in the saline-treated control group. [4] However, to our knowledge, to date, there has been no comparison made of the dosages and durations of antibiotics, which remained under-researched.…”

Peritoneal lavage using chlorhexidine gluconate at the end of colon surgery reduces postoperative intra-abdominal infection in mice

“…Interestingly, the same study showed no significant difference in the occurrence of adhesions between rats that received chlorhexidine gluconate peritoneal lavage compared with the rats that only received saline peritoneal lavage and had fecal peritonitis secondary to colon perforation [18]. Another recent study compared the effect of chlorhexidine gluconate peritoneal lavage to normal saline lavage after colon anastomosis in groups of eight Wistar rats each and showed that chlorhexidine gluconate promoted stronger peritoneal adhesions in rats with induced peritonitis [24]. In our study, we demonstrated no significant difference in the occurrence of macroscopic adhesions among mice groups that had peritoneal lavage with chlorhexidine gluconate solutions and those that had peritoneal lavage with saline only after cecal perforation, peritoneal contamination, and partial cecectomy.…”