Hum. Reprod. Advance Access originally published online on August 24, 2007
Human Reproduction 2007 22(10):2702-2706; doi:10.1093/humrep/dem114
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Effects of supplemental perioperative oxygen on post-operative abdominal wound adhesions in a mouse laparotomy model with controlled respiratory support*
1 Université d'Auvergne—Clermont I, Faculté de Médecine, Centre d'Endoscopie et des Nouvelles Techniques Interventionnelles (CENTI), Clermont-Ferrand, France 2 CHU Clermont-Ferrand, Polyclinique-Hôtel-Dieu, Gynécologie Obstétrique et Médecine de la Reproduction, Boulevard Léon Malfreyt, 63058 Clermont-Ferrand Cédex, France 3 CHU Clermont-Ferrand, Hôtel Dieu, Service d'Anesthésie Réanimation, Clermont-Ferrand, France 4 CHU Clermont-Ferrand, Hôtel-Dieu, Service d'Anatomie et cytologie pathologiques, Clermont-Ferrand, France
5 Correspondence address. Tel: +33-4-73-75-01-38; Fax: +33-4-73-93-17-06. E-mail: sachikoma{at}aol.com
BACKGROUND: Post-operative adhesion formation is a major clinical problem. Tissue oxygenation is one of the most important determinants in adhesion formation. The objective of this study was to investigate whether supplemental perioperative oxygen could reduce post-operative adhesion formation through increasing the peritoneal tissue oxygen tension (PitO2) in a mouse model.
METHODS: Adult C57BJ6 mice were randomly assigned to two groups: Group 1 (n = 20), Fraction of Inspired Oxygen (FiO2): 0.21; Group 2 (n = 20), FiO2: 0.80. On day 0, over the course of the 90 min procedure including the 60 min of laparotomy, PitO2 was continuously monitored. On day 7, a second laparotomy was performed to assess abdominal wound adhesions. Real-time RT–PCR was performed to measure expression levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) mRNA in peritoneal tissues.
RESULTS: The PitO2 levels in Group 2 were significantly higher compared to Group 1 (P < 0.001) and controls (P < 0.003). There was no significant difference in the incidence of abdominal wound adhesions; however, the severity of adhesions was significantly reduced in Group 2 compared to Group 1 (P < 0.03). A significantly higher tPA/PAI-1 mRNA ratio was detected in Group 2 and the controls compared to Group 1 (P < 0.02 and P < 0.002, respectively).
CONCLUSIONS: Supplemental perioperative oxygen may help to reduce post-operative adhesion formation.
Key words: post-operative adhesions/peri-operative oxygen/plasminogen activator inhibitor-1/tissue plasminogen activator/abdominal wound
* Presented in part at the 62nd Annual Meeting of the American Society for Reproductive Medicine, New Orleans, Louisiana, 21–25 October 2006.