Influence of peroperative lavage solutions on peritoneal defence mechanisms in vitro

Abstract

Objective: To find out the in vitro reaction of mesothelial cells and polymorphonuclear leucocytes (PMN) to incubation with seven commonly-used lavage solutions. Design: Experimental study. Setting: Laboratories, The Netherlands. Material: Cultured human peritoneal mesothelial cells and isolated PMN. Intervention: Incubation of cells with clinically used lavage solutions (sodium chloride, Hartmann's solution, povidone-iodine, Dakin's solution, taurolidine, chlorhexidine, and hydrogen peroxide). Main outcome measures: Activation of monolayers of mesothelial cells and PMN measured by release of oxygen free radicals (chemiluminescence) and interleukin (IL)-8 concentrations and toxic effects measured by morphology, release of lactate dehydrogenase, failure of the restriction of the passage of inulin, and incorporation of propidium iodide. Results: All solutions activated and killed mesothelial cells and PMN to some extent; the more concentrated the solution the greater the effect on these cells. Conclusion: Lavage solutions both poison and stimulate mesothelial cells and neutrophils, and some solutions are more potent than others.