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J R Soc Med 1989;82:534-535
© 1989 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 82, Issue 9 534-535, Copyright © 1989 by Royal Society of Medicine

ORIGINAL ARTICLES

Intra-abdominal adhesions and their prevention by topical tissue plasminogen activator

D Menzies and H Ellis
Department of Surgery, Westminster Hospital, London.

Recent work shows that a common pathway in adhesion production is a reduction in local plasminogen activator activity (PAA). This deficit permits deposited surface fibrin to become organized to fibrous adhesions. A rabbit model for adhesion formation was used to assess the effect of replacing the deficit with recombinant tissue plasminogen activator (rt-PA). Adhesions were produced by stripping peritoneum from corresponding parietal and visceral areas. One week later the adhesions were divided. Either rt-PA or placebo was applied to the divided adhesion. After a further week the animal was killed and the adhesions assessed. Sixty strips were performed. Fifty-five adhesions were produced (92%). Placebo gel was applied to 28 sides and rt-PA applied to 27. Twenty-two of the placebo group recurred (79%). Two of the rt-PA group reformed (7%, chi 2 = 20.883, P less than 0.001). Recombinant tissue plasminogen activator is an effective inhibitor of adhesion formation in the experimental animal.
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