Effects of Peritoneal Lavage with Scolicidal Agents on Survival and Adhesion Formation in Rats

Abstract

Intraoperative irrigation of the peritoneal cavity with scolicidal agents is frequently recommended when dealing with traumatic or spontaneous rupture of hydatid cysts. The present experimental study was designed to examine the influence of various scolicidal agents on adhesion formation and survival. A total of 149 rats were randomly allocated to nine groups. Peritoneal lavage through a median laparotomy was performed with the following scolicidal agents. Group 1 (0.9% saline: controls), group 2 (20% hypertonic saline), group 3 (0.04% chlorhexidine gluconate), group 4 (3% hydrogen peroxide), group 5 (0.5% silver nitrate), group 6 (1% polyvinylpyrrolidone-iodine, or PVP-I ), group 7 (5% PVP-I), group 8 (0.5% cetrimide/0.05% chlorhexidine), and group 9 (10% PVP-I). The surviving animals were sacrificed on postoperative day 15. Adhesion formation was macroscopically graded by the Nair criteria. The severity of adhesion formation was evaluated microscopically using the fibrosing scoring criteria and the strain test. Group 9 (10% PVP-I) was excluded from the adhesion evaluation because all of the rats died in this group. The mortality rate was significantly higher in groups 5 and 7 than in groups 1, 2, 3, 4, 6, and 8. Adhesion scores were significantly lower in groups 1, 2, 3, and 4 than in groups 5, 6, 7, and 8. The lowest adhesion score was found in group 3 and the highest in the group 7. These results indicate that 0.04% chlorhexidine gluconate, the most potent scolicidal agent in vitro and in vivo, was associated with the lowest adhesion formation and mortality among various scolicidal agents in this experimental study.

The Effects of Scolicidal Agent Propolis on Liver and Biliary Tree

“…1,4 Various scolicidal agents such as 95% alcohol, 10% povidone iodine, hypertonic saline, hydrogen peroxide, 5% formalin, silver nitrate, cetrimide, and albendazole have been evaluated for scolicidal effects and hepatobiliary complications in the presence of cystobiliary communications. [10][11][12][13] Sahin et al 12 evaluated the effects of hypertonic saline (20%), povidone-iodine (1%), and silver nitrate (0.5%) on liver and biliary tree and found that the use of these agents resulted in chronic low-grade biliary inflammation. The intensity of the lesions was more remarkable in the silver nitrate group.…”

Surgical Management of Renal Cystic Disease

“…Recent animal experiments found that various concentrations of povidone iodine had high potential for intraperitoneal adhesion, and 10% concentration was lethal to all experimental rats. The 0.04% chlorhexidine gluconate solution was found to be highly efficacious, least toxic, and had the least adhesiogenic potential [36,37]. The safety and efficacy of this solution also has been reported clinically [39••].…”

“…A number of scolicidal solutions are in common use (eg, 10% povidone iodine, 20% hypertonic saline, 3% hydrogen peroxide, albendazole, 0.5% silver nitrate, and 0.04% chlorhexidine gluconate) [36][37][38]. All these solutions have more or less similar scolicidal efficacy; however, these differ in potential for inciting adhesion formation.…”

The Effects of Various Scolicidal Agents on the Hepatopancreatic Biliary System

“…Chx-Glu is not affected by dilution and is not concentration-dependent [9]. In addition, in an experimental study evaluating the effects of scolicidal agents on adhesion formation and survival rate following peritoneal lavage, the best results were found for 0.04% Chx-Glu [38]. In our experimental study, 0.04% Chx-Glu was the least harmful scolicidal agent histopathologically.…”