Prevention of postoperative tubal adhesions. Comparative study of commonly used agents

Tubal abrasions were surgically induced in 25 rhesus monkeys following demonstration of tubal patency. Five monkeys received dexamethasone, promethazine, and ampicillin perioperatively, five received intraperitoneal 10% dextran 40, five received intraperitoneal 32% dextran 70, and 10 received no additional therapy. Fimbrial biopsies were obtained from two additional monkeys treated with 32% dextran 70 before and postoperatively on days 2, 5, and 7. Only those treated with 32% dextran 70 retained tubal patency and avoided development of adhesions, involving fimbria, omentum, ovary, uterus, and bladder. Histologic examination of fimbrial biopsies demonstrated sufficient epithelial repair to have occurred during the 5 days 32% dextran 70 remained in the pelvin cavity to prevent adhesion formation. Following demonstration of tubal patency, tubal abrasions were surgically induced in 25 Macaca mulatta adult female monkeys (rhesus). 5 monkeys received dexamethasone, promethazine, and ampicillin perioperatively; 5 received intraperitoneal 10% dextran 40; 5 received intraperitoneal 32% dextran 70; and 10 received no additional therapy. Fimbrial biopsies were obtained from 2 more monkeys treated with 32% dextran 70 before and postoperatively on days 2, 5, and 7. All of the monkeys tolerated the surgical procedures without overt side effects. Only those monkeys who had been treated with 32% dextran 70 retained tubal patency and avoided development of adhesions, involving fimbria, omentum, ovary, uterus and bladder. Histologic examination of fimbrial biopsies revealed sufficient epithelial repair to have taken place during the 5 days 32% dextran 70 remained in the pelvic cavity to prevent formation of adhesions. The present data confirms and extends the evidence that 10% dextran 40 fails to prevent surgically induced tubal adhesions.