The role of neutrophils in the formation of peritoneal adhesion

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Mohamed Jallouli
Ahmed Hakim
Abir Znazen
Yosr Chaabouni
Zouheir Sahnoun
Adnene Hammami
Khaled Zeghal
Riadh Mhiri

Abstract

Background : The use of antibiotics during peritonitis appears to decrease the formation of postoperative intra peritoneal adhesions and reduce their severity. The effect of this antibiotic is still controversial.
Aim: To study the relationship between the decrease postoperative adhesions induced by rifamycin, and the number of neutrophils and the number of intraperitoneal bacteria.
Methods: This is an experimental prospective, randomized singleblind study performed on adult male rats. The product used for the peritoneal lavage was rifamycin s. The animals were randomized into three groups: Group S: intra peritoneal lavage with saline to 9%, R25 Group: intra peritoneal lavage with rifamycin at a dose of 25 mg / kg group and 12.5 R: intra peritoneal lavage with rifamycin at a dose of 12.5 mg / kg. Adhesions score was evaluated according to Zulkhé by the same operator.
Results: The adhesion score was significantly lower between groups S and R12.5 (p = 0.000) and group S and group R25 (P = 0.01). However, the difference was not significant between the two groups R 25 and R12.5 compared to S group (p = 0.655). The number of bacteria between the time of caecal resection (before peritoneal lavage) and the time of death or sacrifice was significantly decreased significantly in the groups R25, comparing the group S (p = 0.003). However, there is no significant difference between groups S and R12, 5 (p = 0.106). The number of neutrophils between the time of cecal resection (before peritoneal lavage) and the time of death or sacrifice decreased significantly in the groups R25 and R12, 5 in comparison to the group S. Between the group R25 and the S group, the difference is significant (p = 0.037) as well between the group R12, 5 and S (p = 0.026). However, there is no significant difference between the two groups R 25 and R12, 5 (p = 0.712).
Conclusion: The action of rifamycin sodium on neutrophils seems to be independent of its antibacterial action. These findings deserve to be explored at the end to clarify the mechanism of neutropenia by intra peritoneal washing with rifamycin and the relationship between neutropenia and post-operative adhesions.

Keywords:

Rifamycine ; peritonitis ; peritoneal lavage

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