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Peritoneal adhesions in horses: prophylactic treatment with carboxymethylcelullose

Peritoneal adhesions form very often in horses submitted to laparotomy. Adhesions may be assymptomatic or they could cause complications such as colic and intestinal obstruction, sometimes with vascular strangulation. To evaluate intra-peritoneal use of carboxymethylcellulose (CMC) in prevention of peritoneal adhesions in horses, the following experiment was conducted: eighteen clinically normal mixed breed horses were anesthetized and submitted to ventral midline laparotomy. Lesions in the distal jejunum were produced to induce peritoneal adhesion formation. In four horses (block I) six lesions were created: one segment 45cm in length was submitted to ischemia by ocluding mural circulation and mesenteric vessels for two hours; in five small areas with approximately three x five centimeters serosal abrasion was produced by rubbing a dry gauze sponge 100 times with a single chromic catgut suture placed in the center through the seromuscular layer. For the other fourteen animals (block II) the model adopted was similar with small chances: instead of one ischemic segment, four segments 25cm in length were created: abrasïon of the five areas was produced with the jaw of an open Rochester forceps; the suture made in the center of the abrasion areas was a line of a simple continuous pattern with 2.5cm in length approximately. Horses were randomly placed into two groups. In nine animals (treatment group), a volume of 7 ml/kg of 1%cmC was instilled in the peritoneal cavity before abdominal wall synthesis. In the other nine animals (control group) the wall was sutured in the same way, but no drug was instilled in the peritoneal cavity. Horses were monitored daily. All animals were submitted to euthanasiu and necropsy fourteen days after surgery. Six of the nine animals in the control group and four of nine animals of treatment group developed peritaneal adhesions. There were no significant differences between the numher of animals with adhesians in the two groups nor between the number and the grade of adhesions developed in the groups. Animals in the treatment group did not show any sign of toxicity or hypersensivity forcmC. Based on these results it may be concluded that carboxymethylcellulose was not efficient in preventing peritoneal adhesions in equine small intestine induced by serosal abrasion and ischemia. Also it may be concluded that this drug did not cause any collateral effects neither impaired peritoneal healing.

adhesions; peritoneum; abdominal surgery; intestino, equine


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