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Studies of Intestinal Healing IV. Prevention of Adhesions Following Inverting and Everting Bowel Anastomoses With Promethazine and Dexamethasone

Eusebio Kho, MD; Robert Replogle, MD; Mark M. Ravitch, MD
Arch Surg. 1969;98(6):764-765. doi:10.1001/archsurg.1969.01340120112020.
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The clinical use of an antihistamine alone and of adrenocorticoids alone for preventing intestinal adhesions following operation have been reported.1,2 Replogle and co-workers3 advocated the combined use of both agents for the same purpose. Promethazine (Phenergan) and dexamethasone (Decadron) effectively prevented intestinal adhesions in a significant proportion of dogs whose intestine had been scrubbed with a stiff brush. When intestinal adhesions did form, these adhesions were generally less extensive. While they subjected the dog's intestine to extensive serosal trauma, they did not systematically employ bowel anastomoses in their studies.

Testing the promethazine-dexamethasone regimen on inverting and everting end-to-end intestinal anastomoses offered possibilities to: (1) provide a significant test of the possible interference of these drugs with the healing of bowel anastomoses, (2) provide stringent test of the ability of this regimen to prevent adhesions, (3) confirm our previous finding that extensive adhesions were more common following everting anastomoses4


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