Effects of five different barrier materials on postsurgical adhesion formation in the rat.
Postsurgical adhesion formation is a significant clinical problem within every surgical specialism. Due to the problems that adhesions cause, a wide variety of adjunctive treatments to prevent the formation and reformation of adhesions have been proposed. One of the modalities that has been studied extensively and that has been showing the most promising results is the so-called barrier method. The purpose of the present study was to compare the efficacy of five of these barrier materials in the prevention of postsurgical adhesion formation in a standardized rat adhesion model. It was concluded that no beneficial effect of Ringer's lactate on adhesion formation was seen. Significant reductions (P < 0.0001) in adhesion percentages compared to control animals were seen with Polyactive((TM)), PRECLUDE Peritoneal Membrane((TM)), Seprafilm((TM)) and Tissucol((TM)), but only PRECLUDE Peritoneal Membrane and Seprafilm significantly reduced adhesions (P < 0.01) when the barrier-treated peritoneal defects were compared with contralateral control-side peritoneal defects. The results of our study suggest that Seprafilm and PRECLUDE Peritoneal Membrane are superior to Tissucol and Polyactive in preventing adhesion formation. When Polyactive was still attached to the site of application during the second laparotomy, similar results to Seprafilm and PRECLUDE Peritoneal Membrane were seen. Future studies on the efficacy of a material to decrease adhesion formation should always include a comparison of several control materials in the same model. Our study indicates that Seprafilm or PRECLUDE Peritoneal Membrane might be used as standards of control.
Hellebrekers
B W
BW
Department of Gynecology, Leiden University Medical Center, The Netherlands. bwjh@xs4all.nl
Trimbos-Kemper
G C
GC
van Blitterswijk
C A
CA
Bakkum
E A
EA
Trimbos
J B
JB
D000704:Analysis of Variance; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006820:Hyaluronic Acid; D010532:Peritoneal Diseases / Q000473:pathology / Q000517:prevention & control*; D010537:Peritoneum / Q000473:pathology / Q000601:surgery*; D011091:Polyesters / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive; D011091:Polyesters; C118198:Seprafilm; C072932:polyethylene oxide-polybutylene terephthalate copolymer; D011092:Polyethylene Glycols; D011138:Polytetrafluoroethylene; D006820:Hyaluronic Acid