A randomized clinical trial of oxidized regenerated cellulose adhesion barrier (Interceed, TC7) alone or in combination with heparin.
OBJECTIVE
To compare the efficacy of heparin-saturated oxidized regenerated cellulose absorbable adhesion barrier, Interceed (TC7; Johnson and Johnson Medical Inc., New Brunswick, NJ) to oxidized regenerated cellulose alone for the prevention of postoperative adhesions.


METHODS
Clinical trial. By random assignment, one ovary was wrapped in oxidized regenerated cellulose, and the contralateral ovary was wrapped in oxidized regenerated cellulose saturated with a heparin solution (1,000 U/mL).


METHODS
Forty women with defects on both ovaries due to adhesiolysis and/or ovarian cystectomy.


METHODS
Adhesion formation and raw ovarian surface area were assessed at second-look laparoscopy 10 days to 16 weeks later.


RESULTS
At the second-look laparascopy-adhesions were present on 52.5% (21/40) of the ovaries treated with oxidized regenerated cellulose plus heparin and in 65% (26/40) of the contralateral ovaries treated with oxidized regenerated cellulose alone. For ovaries treated with oxidized regenerated cellulose plus heparin, the raw surface area was reduced from 9.41 +/- 1.27 cm2 (mean +/- SE) at laparotomy to 1.33 +/- 0.52 cm2 at second-look laparoscopy. The corresponding figures for ovaries treated with oxidized regenerated cellulose alone were from 10.24 +/- 1.08 to 1.92 +/- 0.54 cm2, respectively. The mean difference between the reductions in raw surface area (85.9% for oxidized regenerated cellulose plus heparin; 81.3% for oxidized regenerated cellulose alone) was not significantly different from zero (difference = - 0.24 cm2; 95% confidence interval = -2.56 to 3.04).


CONCLUSIONS
Adding heparin did not enhance significantly the adhesion-reducing capacity of oxidized regenerated cellulose adhesion barrier when applied to ovarian surfaces after cystectomy and/or ovariolysis at laparotomy. This conclusion is subject to the possibility of a type II error.
Reid
R L
RL
Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada. reidr@post.queensu.ca
Hahn
P M
PM
Spence
J E
JE
Tulandi
T
T
Yuzpe
A A
AA
Wiseman
D M
DM
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D002483:Cellulose, Oxidized / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000517:prevention & control*; D010053:Ovary / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D000267:Tissue Adhesions / Q000517:prevention & control
D000925:Anticoagulants; D002483:Cellulose, Oxidized; C060002:INTERCEED; D006493:Heparin