Effects of laparoscopic lavage on adhesion formation and peritoneum in an animal model of pelvic inflammatory disease.

STUDY OBJECTIVES: To develop an animal model of pelvic inflammatory disease (PID) that simulates intraluminal tubal damage and adhesion formation seen in human PID, and to evaluate peritoneal effects of laparoscopic lavage with 1% povidone-iodine, 0.5% povidone-iodine, and 0.05% chlorhexidine gluconate solutions.

DESIGN: Prospective, randomized, controlled study (Canadian Task Force classification I).

SETTING: Animal research operating room facility.

SUBJECTS: Forty-five 1-year-old Pasteurella-free New Zealand white rabbits.

INTERVENTION: Laparoscopy with instillation of one of five lavage solutions after bacterial inoculation with Neisseria gonorrhoeae, Bacteroides fragilis, Escherichia coli, and Peptococcus niger.

MEASUREMENTS AND MAIN RESULTS: Histologic evaluation revealed significantly more peritoneal inflammation after lavage with all three solutions than after no lavage or lavage with normal saline. Gross adhesion formation was visible in only one rabbit after lavage with normal saline. One animal having lavage with 1% povidone-iodine died immediately after injection for sedation before laparoscopic lavage, and was not included in the final results.

CONCLUSION: Bacterial inoculation using an intrauterine insemination catheter did not produce clinical adhesions in 43 of 44 rabbits. Histologic evaluation revealed significantly more peritoneal inflammation in the lavage with povidone-iodine and chlorhexidine gluconate compared with no lavage or lavage with normal saline.