Postoperative adhesion formation is a major problem in abdominal surgery. The effect of mesothelial cell cover on adhesion formation after peritoneal injury was experimentally investigated in rats. Human placental membranes were used as the source of mesothelial tissue. Amnion and chorion cell suspension application to the injured area proved feasible and thus a sutureless repair technique was obtained. Forty rats were divided into four groups: amnion cell repair, chorion cell repair, injury without repair and sham operation. Fourteen days later the adhesion formation was assessed macroscopically and microscopically. Although allegedly immunologically inert, the mesothelial cells evoked a local lymphocytic infiltration in the host, which was significantly more pronounced in the amnion repair group. Accordingly, the macroscopic assessment revealed significantly enhanced adhesion formation in this group, as compared to the control and chorion groups. It is concluded that peritoneal injury probably should not be repaired at all. Although it was suggested recently that mesothelial tissue might play a preventive role in adhesion formation, our findings seem to suggest that amnion cells exert an enhancing influence, perhaps acting as a ‘topical tissue plasminogen deactivator’.

Keywords:
Peritoneum, Intra-abdominal adhesions, Amnion, Chorion, Peritoneal injury
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© 1993 S. Karger AG, Basel
1993
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