Autologous peritoneal grafts permit rapid reperitonealization and prevent postoperative abdominal adhesions in an experimental rat study

Background Reperitonealization has attracted increasing attention for its potential to prevent postoperative abdominal adhesions and subsequent related complications. We studied the effect of an autologous peritoneal graft on reperitonealization and prevention of adhesions in a rat model. Methods A standardized peritoneal lesion was induced on the parietal peritoneum by electrocoagulation and sutures. Twenty adult rats sustaining these lesions were randomized to 1 of 4 groups: (1) autologuous peritoneal graft with the side of mesothelial cells exposed to the abdominal cavity; (2) autologuous peritoneal graft with the side of subserosa containing fibroblasts exposed to the abdominal cavity; (3) cell sheet consisting of autologuous mesothelial cells and fibroblasts; or (4) nontreated group (Control). Fourteen days after the operation, abdominal adhesions were evaluated by macroscopic observation and histologic assessment. Results Macroscopic observation revealed that in mesothelial cells/fibroblasts grafts, there was no adhesion on the surface of the peritoneal graft covering the lesion. In contrast, in the other 3 groups, all rats obviously revealed extended and severe adhesions. Histology showed that mesothelial cells exist on the surface of the graft in mesothelial cells/fibroblasts graft, but no mesothelial cells were observed in the samples from the other groups. Conclusion Autologous peritoneal grafts prevented postoperative abdominal adhesions in this rat model. As the mechanism of this prevention, the mesothelial cells survived and contributed to reperitonealization, only when they were transplanted as a part of the autologous peritoneal grafts and were located on the surface exposed to the abdomen.