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ADHESIONS RESULTING FROM REMOVAL OF SEROSA FROM AN AREA OF BOWEL: Failure of Oversewing to Lower Incidence in the Rat and the Guinea Pig

ADHESIONS RESULTING FROM REMOVAL OF SEROSA FROM AN AREA OF BOWEL: Failure of Oversewing to Lower... Abstract IT HAS been a common clinical practice to "reperitonealize" areas of injury to the visceral peritoneum in order to prevent the formation of adhesions between such areas and omentum, intestine or other intraabdominal structures. The usual method of doing this for serosal injuries to the bowel is to draw adjacent uninjured serosa together over the area of injury with interrupted sutures of a fine nonabsorbable material, such as 0000 silk, taking delicate bites of tissue with a small round-pointed needle. Experiments carried out by Chandy in this laboratory have indicated that silk itself commonly becomes encapsulated by omentum and that the usual seromuscular stitch tied in place would, of itself, produce an adhesion in the experimental animal (rat). EXPERIMENTAL STUDIES The following experiments were carried out to see if the incidence of adhesions resulting from areas of bowel denuded of serosa was reduced or increased by oversewing.The animals used References 1. Richardson, E. H.: Studies on Peritoneal Adhesions , Ann. Surg. 54:758, 1911.Crossref 2. Coudry, E. V.: Textbook of Histology , Philadelphia, Lea & Febiger, 1934, p. 235. 3. Hertzler, A. E.: The Peritoneum , St. Louis, C. V. Mosby Company, 1919, vol. 1, chapter on adhesions. 4. Karsner, H. T.: Textbook of Human Pathology , Philadelphia, W. B. Saunders Company, 1936, chaps. 1 and 19. 5. Three rats and 2 guinea pigs included here died before the sixth postoperative day. Their exclusion would not materially affect the statistical analysis. 6. Robbins, G. F., Brunschwig, A., and Foote, F. W.: Deperitonealization: Clinical and Experimental Observations , Ann. Surg. 130:466, 1949.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

ADHESIONS RESULTING FROM REMOVAL OF SEROSA FROM AN AREA OF BOWEL: Failure of Oversewing to Lower Incidence in the Rat and the Guinea Pig

Archives of Surgery , Volume 61 (3) – Sep 1, 1950

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Publisher
American Medical Association
Copyright
Copyright © 1950 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1950.01250020570015
Publisher site
See Article on Publisher Site

Abstract

Abstract IT HAS been a common clinical practice to "reperitonealize" areas of injury to the visceral peritoneum in order to prevent the formation of adhesions between such areas and omentum, intestine or other intraabdominal structures. The usual method of doing this for serosal injuries to the bowel is to draw adjacent uninjured serosa together over the area of injury with interrupted sutures of a fine nonabsorbable material, such as 0000 silk, taking delicate bites of tissue with a small round-pointed needle. Experiments carried out by Chandy in this laboratory have indicated that silk itself commonly becomes encapsulated by omentum and that the usual seromuscular stitch tied in place would, of itself, produce an adhesion in the experimental animal (rat). EXPERIMENTAL STUDIES The following experiments were carried out to see if the incidence of adhesions resulting from areas of bowel denuded of serosa was reduced or increased by oversewing.The animals used References 1. Richardson, E. H.: Studies on Peritoneal Adhesions , Ann. Surg. 54:758, 1911.Crossref 2. Coudry, E. V.: Textbook of Histology , Philadelphia, Lea & Febiger, 1934, p. 235. 3. Hertzler, A. E.: The Peritoneum , St. Louis, C. V. Mosby Company, 1919, vol. 1, chapter on adhesions. 4. Karsner, H. T.: Textbook of Human Pathology , Philadelphia, W. B. Saunders Company, 1936, chaps. 1 and 19. 5. Three rats and 2 guinea pigs included here died before the sixth postoperative day. Their exclusion would not materially affect the statistical analysis. 6. Robbins, G. F., Brunschwig, A., and Foote, F. W.: Deperitonealization: Clinical and Experimental Observations , Ann. Surg. 130:466, 1949.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1950

References