Donna C. Koo MD , P. Nina Scalise MD , Claire A. Ostertag-Hill MD , Abbie E. Naus MD , Jonathan M. Durgin MD , Megan Z. Chiu MD , Melissa Mejia Bautista MD , Kamila Moskowitzova MD , Steven J. Staffa MS , Gabriel Ramos Gonzalez MD , Alyaa Al-Ibraheemi MD , Eliza J. Lee MD , Farokh R. Demehri MD , Heung Bae Kim MD
{"title":"Polyvinyl Alcohol Sponges Reduce Intraperitoneal Adhesions After Abdominal Surgery","authors":"Donna C. Koo MD , P. Nina Scalise MD , Claire A. Ostertag-Hill MD , Abbie E. Naus MD , Jonathan M. Durgin MD , Megan Z. Chiu MD , Melissa Mejia Bautista MD , Kamila Moskowitzova MD , Steven J. Staffa MS , Gabriel Ramos Gonzalez MD , Alyaa Al-Ibraheemi MD , Eliza J. Lee MD , Farokh R. Demehri MD , Heung Bae Kim MD","doi":"10.1016/j.jss.2025.02.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>The use of cotton sponges in the operating room has been linked to intraperitoneal adhesion formation. Inert, nonlinting polyvinyl alcohol (PVA) sponges have been used as an alternative to reduce intraoperative tissue trauma and particle remnants in other surgical fields. We investigate the effect of PVA sponges on reducing postoperative intraperitoneal adhesions in a murine model.</div></div><div><h3>Methods and methods</h3><div>In total, 189 C57BL/6 mice were randomly divided into three groups by abdominal packing intervention. Following laparotomy on day 0, the abdominal cavity was packed with cotton gauze (<em>n</em> = 53), PVA wipe (<em>n</em> = 54), or no packing (sham; <em>n</em> = 58) for three rounds of 10 min each before packing was removed. Mice were euthanized, and necropsies were performed between postoperative days 13-15. Adhesions were graded by two blinded observers using a validated system composed of adhesion extent, tenacity, and density. Adhesion scores were compared between the three groups.</div></div><div><h3>Results</h3><div>Compared to adhesions in gauze-packed mice, adhesions in PVA-packed mice were significantly less extensive, less tenacious, and less dense (<em>P</em> < 0.001 for all), which equated to lower total adhesion scores in PVA-packed mice (0 [0, 3] <em>versus</em> 5 [2, 7], <em>P</em> < 0.001). The adhesion scores for sham group mice were significantly lower than PVA and gauze mice in all categories.</div></div><div><h3>Conclusions</h3><div>This is the first study to directly compare postoperative intra-abdominal adhesion formation following the use of gauze and PVA sponges in an animal model. PVA sponges significantly reduce postoperative adhesions when compared to standard cotton gauze sponges. PVA should be further explored as a useful alternative to reduce postoperative adhesion-related morbidity.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 183-192"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022480425000642","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
The use of cotton sponges in the operating room has been linked to intraperitoneal adhesion formation. Inert, nonlinting polyvinyl alcohol (PVA) sponges have been used as an alternative to reduce intraoperative tissue trauma and particle remnants in other surgical fields. We investigate the effect of PVA sponges on reducing postoperative intraperitoneal adhesions in a murine model.
Methods and methods
In total, 189 C57BL/6 mice were randomly divided into three groups by abdominal packing intervention. Following laparotomy on day 0, the abdominal cavity was packed with cotton gauze (n = 53), PVA wipe (n = 54), or no packing (sham; n = 58) for three rounds of 10 min each before packing was removed. Mice were euthanized, and necropsies were performed between postoperative days 13-15. Adhesions were graded by two blinded observers using a validated system composed of adhesion extent, tenacity, and density. Adhesion scores were compared between the three groups.
Results
Compared to adhesions in gauze-packed mice, adhesions in PVA-packed mice were significantly less extensive, less tenacious, and less dense (P < 0.001 for all), which equated to lower total adhesion scores in PVA-packed mice (0 [0, 3] versus 5 [2, 7], P < 0.001). The adhesion scores for sham group mice were significantly lower than PVA and gauze mice in all categories.
Conclusions
This is the first study to directly compare postoperative intra-abdominal adhesion formation following the use of gauze and PVA sponges in an animal model. PVA sponges significantly reduce postoperative adhesions when compared to standard cotton gauze sponges. PVA should be further explored as a useful alternative to reduce postoperative adhesion-related morbidity.
期刊介绍:
The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories.
The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.