A comparative study of the effects of thrombin and electrodesiccation used for haemostasis on inflammation and adhesion formation

Abstract

Electrodesiccation or chemical agents, such as thrombin and fibrin sealant, may be used to control oozing in the peritoneal cavity. Electrodesiccation is time consuming and associated with adjacent thermal damage. Adhesion formation remains a concern with the use of thrombin and fibrin sealant. In this study, adhesion formation and various histological parameters of inflammation were evaluated following haemostasis with electromicrodesiccation or thrombin in the rabbit model (n = 36). Following laparotomy, the right uterine horn was subjected to a measured injury producing sufficient oozing. After the injury was effected, the animals were randomized to haemostasis with electromicrodesiccation (n = 18) or thrombin (n = 18). In the first phase of the study, the histological parameters of acute injury and haemostasis with either modality were evaluated in two animals in each group. In the second phase, one, two and 10 animals, in each group, were submitted to second-look laparotomy on post-operative days 2, 7, and 15, respectively and the type and extent of adhesions were quantified. Histological parameters of inflammation as well as the type and extent of adhesions were comparable between the two groups. We conclude that local application of thrombin is not associated with a statistically greater degree of post-operative adhesions when compared to electromicrodesiccation.

A Prospective Experimental Study to Investigate the Peritoneal Adhesion Formation of Argon Plasma Coagulation (APC) Versus a Novel Aerosol Plasma in a Rat Model

“…The intra-abdominal temperature, desiccation, and possible humidification are factors that change the conditions on the mesothelial cell lining. [26][27][28][29] In both types of lesions, the adhesions can be seen at the top of the picture. In deeper layers of the abdominal wall, the necrotic muscle fibers can be seen with surrounding granulation tissue formation.…”