Time to reconsider saline as the ideal rinsing solution during abdominal surgery

The Impact of 0.9% NaCl on Mesothelial Cells After Intraperitoneal Lavage During Surgical Procedures

“…As a consequence of peritoneal lesions the production of tPA, the main fibrinolytic stimulator, decreases rapidly and the release of PAI-1 is simultaneously stimulated [5,18]. Recent reports have confirmed that the relationship between tPA and PAI-1 activities plays an important role in adhesiogenesis [12,19]. In the present study lavage fluid containing bile intensified PAI-1 synthesis.…”

“…It is suspected that normal saline may cause a variety of adverse reactions, e.g. depression of fibrinolytic activity, oxygen free radical generation and proinflammatory cytokine synthesis [12,13]. The results of previous research published by the present authors and others suggested that use of 0.9% NaCl solution in an intraabdominal lavage may lead to the formation of peritoneal adhesions [12,13].…”

Extensive peritoneal lavage decreases postoperative C-reactive protein concentrations: a RCT

“…High volumes of fluid at a lower temperature indeed might affect the core body temperature. Considering that saline can be harmful to mesothelial cells, causing retraction and bulging [19,30,31], a richer solution, as Ringer's lactate, might be preferable. This also explains that adhesions increase after lavage with saline supplemented with 1 % povidone-iodine, 0.5 % povidone-iodine or 0.05 % chlorhexidine gluconate [32] probably through mesothelial cell trauma.…”

Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

“…[20] van Westreenen et al have also suggested stimulation of intraperitoneal adhesions with perioperative lavage. [19] In this rat study, uterine horns were attached to the suture placed lateral to the wall of the abdomen, and 10 ml of lavage (25 °C) for 10 min was applied.…”

“…When saline lavage or installation is included into the experimental groups, three different results are observed; beneficial, [10][11][12][13][14] ineffective, [9,[15][16][17][18] or even harmful. [19,20] Another challenge in peritoneal adhesion studies is the use of several different models. Two major problems caused by peritoneal adhesions are intestinal obstruction and infertility.…”