The influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions

<p>Abstract</p> <p>Background</p> <p>The formation of adhesions following abdominal surgery is a well known problem. In previous studies we demonstrated the efficacy and safety of intraperitoneally applied phospholipids in order to prevent adhesion formation. This study evaluates the influence of blood on the efficacy of intraperitoneally applied phospholipids for prevention of adhesions.</p> <p>Methods</p> <p>In 40 Chinchilla rabbits adhesions were induced by median laparotomy, standardized abrasion of the visceral and parietal peritoneum in defined areas of the ventral abdominal wall and the caecum. The animals were randomly divided into four groups. They received either phospholipids 3.0% or normal saline (NaCl 0,9%) (5 ml/kg body weight). In 50% of the rabbits we simulated intraperitoneal bleeding by administration of blood (1,5 ml/kg body weight). The other half served as control group. Ten days following the operation the animals were sacrificed and adhesion formation was assessed by computer aided planimetry and histopathologic examination.</p> <p>Results</p> <p>The median adhesion surface area in the NaCl-group (n = 9) amounted to 68,72 mm², in the NaCl+Blood-group (n = 10) 147,68 mm². In the Phospholipid (PhL)-group (n = 9) the median adhesion surface area measured 9,35 mm², in the PhL+Blood-group (n = 9) 11,95 mm². The phospholipid groups had a significantly smaller adhesion surface area (p < 0.05).</p> <p>Conclusion</p> <p>Again these results confirm the efficacy of phospholipids in the prevention of adhesions in comparison to NaCl (p = 0,04). We also demonstrated the adhesion preventing effect of phospholipids in the presence of intraperitoneal blood.</p

The different states of the United States differ considerably in the proportion of surgery performed without admission to hospital

<p><b>Copyright information:</b></p><p>Taken from "The evolution of sites of surgery"</p><p></p><p>The Ulster medical journal 2006;75(1):46-53.</p><p>Published online Jan 2006</p><p>PMCID:PMC1891798.</p><p>© The Ulster Medical Society, 2006</p> These figures provided by the American Hospital Association include only hospital-based surgery. Free-standing surgicenter and MD office-based surgery are excluded (see ). The differences between states may reflect different state laws and regulations, county and other local ordinances, as well as demographic factors and variations in physician practice patterns. US presidential electoral voting results for each state are indicated as red for Republican candidates and blue for Democratic Party candidates. The 1993 panel is mapped to the 1992 presidential election (GHW Bush versus WJ Clinton), the 1998 to the 1996 election (WJ Clinton versus R Dole) and the 2003 to the presidential election of 2000 (A Gore versus GW Bush). There appears to be no association between a state's political orientation and the percentage of surgery performed without admission to hospital