EFEITOS DA LAVAGEM ABDOMINAL E DA OZONIZAÇÃO SOBRE A FORMAÇÃO DE ADERÊNCIAS ABDOMINAIS E A CICATRIZAÇÃO

Abstract

Peritoneal adhesions are still an unsolved problem in medicine, in which there is still no consensus on their prevention and, therefore, generates great social and economic impact worldwide. In order to define the best strategy to prevent adhesiolysis, different solutions for abdominal lavage were analyzed, for which 30 rats (Rattus norvegicus) were randomly assigned to groups of six animals in five treatments (control, 0.9% NaCl, glucose 5%, ringer with lactate and NaCl 0.9% plus ozone at a concentration of 48µg O3/ml). After anesthesia, the experimental units were submitted to diagnostic peritoneal lavage and blood collection. Laparotomies were performed pre-retroumbilical with a total of 4 cm and then scarification of the cecum and peritoneum was performed, the cavity remained open for 5 minutes and then 20 ml/kg of the solution to be tested was infused. Abdominal discomfort and nociception were assessed daily using behavioral assessments and the Grimace scale. On day 21, the rats were again anesthetized and submitted to abdominal lavage and blood collection and were immediately euthanized and two paramedian incisions parallel to the operated region and two transversal were performed, allowing the evaluation of adhesions. Afterwards, the flap was excised, divided into two parts and stored in a 4% buffered formalin solution, with an abdominal strip destined for the microtensile test to evaluate the tissue's resistance and elasticity, while the other sample was destined for histopathological evaluation, receiving ordinal scale assignment (absent, mild, moderate and marked) according to histological findings. The results obtained allowed us to conclude that, in rats, the 0.9% NaCl solution plus ozone at a concentration of 48µg O3/ml, when used for abdominal lavage after laparotomy, provides an earlier skin healing, reduces serum biomarkers of inflammation, accelerates the healing process of myorrhaphy, increases scar resistance to traction, and decreases the formation of peritoneal adhesions through attenuation of inflammation and enhancement of angiogenesis. Thus, it is considered to be the most suitable for the transoperative period.