The aim of the study was to evaluate adhesive properties of the surgical anti-adhesion barrier based on collagen in combination with 0.05% Chlorhexidine bigluconate solution and Prontosan in experiment performed in vitro. Materials and Methods. The study was carried out using CollaGUARD adhesion barrier consisting of renatured horse type I collagen and reference strains of Еscherichia coli АТСС ® 25922, Klebsiella pneumoniae АТСС ® 700603, Pseudomonas aeruginosa АТСС ® 27853, Staphylococcus aureus АТСС ® 25923. Bacteria adhesion to the barrier (membrane) untreated and combined with biocides was evaluated by determining the viable colony forming unit (CFU/cm 2) numbers and using atomic force microscopy after 24 h and 6 days. Results. Cells of all bacterial strains adhered to the surface of the membrane within 24 h forming a biofilm of bacilli tightly adjacent to each other (E. coli, P. aeruginosa) or cocci (S. aureus) integrated between disorganized collagen fibers, or adherent bacteria were seen separately (K. pneumoniae). The Sq index characterizing the surface roughness of the biofilm formed by S. aureus bacteria was 221.3±38.6 nm and was 3.0, 3.8, and 3.6 times higher compared with that for E. coli (72.8±12.6 nm), K. pneumoniae (57.5±21.8 nm), and P. aeruginosa (60.8±22.1 nm), respectively, and also exceeded 4.4 times the Sq index for the membrane itself (50.3±26.3 nm). Collagen degradation was revealed in case of contamination by protease-producing bacteria with collagenase activity: P. aeruginosa for 24 h and S. aureus for 6 days. Adsorption of the biocide on the membrane surface after its short exposure to Chlorhexidine bigluconate solution or Prontosan led to inhibited growth and adhesion of cells of bacteria, except for P. aeruginosa. In experimental models, in agar medium and in suspension culture, Chlorhexidine bigluconate proved to be more effective than Prontosan. The difference between the biocides in inhibiting the adhesion of bacteria to the membrane surface is not associated with changes in its surface roughness. Conclusion. Impregnation of a surgical membrane with antibacterial compounds just before the implantation can serve as an additional method for preventing abdominal surgical infection.
Peritoneal adhesion (PA) is still an actual surgical issue. It is known that any surgical intervention causes abdominal adhesion that, in its turn, induces a number of complications such as adhesive intestinal obstruction. There is registered a high lethality among patients with the developed acute adhesive intestinal obstruction. Adhesive intestinal obstruction hurts health of patients, leading to eight (on average) days of hospitalization and intrahospital lethality of 3 % per episode. The cause of the development of a significant number of lethal cases is imperfection of preventive, diagnostic, therapeutic measures; 20 to 30 % of patients with adhesive intestinal obstruction need surgical treatment. Heavy expenses in the system of healthcare are required for treatment of peritoneal adhesions. The review presents the data regarding modern state of the problem, advanced tendencies in diagnosis, prevention and treatment of patients with peritoneal adhesions, their use in practical studies.
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