Prevention of intestinal seal insurance under experimental expanded peritonitis

Purpose. To prevent the development of intestinal suture incompetence in conditions of experimental widespread peritonitis by introducing an immobilized form of an antiseptic miramistin into the abdominal cavity, as well as using a suture material impregnated with an antiseptic. Materials and methods. The experiment was carried out on 288 male Wistar rats divided into 3 groups of 96 animals each. Modeling of peritonitis was carried out by introducing 10% fecal matter into the abdominal cavity. After 24 hours, a laparotomy was performed, then the abdominal cavity was washed with sterile saline and a 1 cm wound was applied to the colon wall, which in the first (control) group of animals was sutured with a polyglycolide thread without an antibacterial coating, in the second group-with a polyglycolide thread covered with a polymer solution, containing 10% miramistin by weight of the polymer, and in the third group - with a polyglycolide thread covered with a polymer solution containing 20% miramistin by weight of the polymer. At the final stage, the animals of the second and third groups were injected into the abdominal cavity with 5 ml of immobilized form of miramistin based on sodium salt of carboxymethylcellulose. The animals were taken out of the experiment on days 1, 3, 7 after the operation. The frequency of suture failure and the percentage of lethality of animals in each group were calculated. The sections of the large intestine in the area of the suture were taken for histological examination. Results. Intestinal suture failure developed in 48% of animals in the first group, in 32.3% in the second and 18% in the third group, and deaths were recorded in 79.2%, 50% and 37.2%, respectively. of the first group, a pronounced inflammatory reaction persisted at all periods of the experiment. In the second group, by the end of the experiment, a decrease in the intensity of inflammation was noted. In the third group, a decrease in the zones of necrosis and neutrophil-lymphocytic infiltration was revealed by the 3rd day until complete disappearance by the 7th day of the experiment. Conclusion. The introduction of an immobilized form of miramistin into the abdominal cavity and the imposition of an intestinal suture with a polyglycolide thread covered with a polymer solution containing 10% and 20% of miramistin by weight of the polymer is pathogenetically substantiated and effective under conditions of peritonitis.