Efficacy of anti-adhesive barriers in secondary thyroidectomy: an experimental study.
OBJECTIVE
This study was conducted to compare the effectiveness of two anti-adhesive barriers (Seprafilm and Interceed) for reducing adhesions after thyroidectomy in a rat model. The anti-adhesive barriers are suggested for use in repeated surgeries in general and the gynecologic fields in particular.


METHODS
Controlled, randomized study.


METHODS
Twenty-eight male Wistar Albino rats that underwent right subtotal thyroidectomy were randomly assigned to three groups. One group received Seprafilm (n = 10), and the other received Interceed (n = 10) as anti-adhesive barriers. The third group was the control group (n = 8). At postoperative day 14, the rats were killed under general anesthesia, and the surgical fields were evaluated for the adhesion formation. The extent of the adhesion formation is scored from 0 (no adhesions) to 2 (fibrous adhesions that required sharp dissection). Histopathologically, chronic inflammation, histiocyte, fibroblast, fibrosis, collagen, vascularization, granuloma, giant cell, and fat necrosis were examined.


RESULTS
All the subjects in the control group, 7 of 10 in the Interceed group, and 4 of 10 in the Seprafilm group needed to be dissected bluntly or sharply. There was significant difference between the Seprafilm and the control group (P < .05) whereas there was no significant difference between the Interceed group and the control group (P > .05). When examined histopathologically, the criteria showing adhesion, such as fibrosis, fibroblast, and collagen were higher in the control group compared with the Seprafilm and Interceed groups. There was no significant difference between the Seprafilm and Interceed groups, whereas a significant difference was found between these two groups and the control group.


CONCLUSIONS
This study suggests that both Seprafilm and Interceed decrease the incidence of posthyroidectomy adhesions in a rat model. Both agents showed no foreign body reaction.
Department of Otorhinolaryngology, Head and Neck Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Ozgur
O
Yigit
Berna
B
Uslu Coskun
Halil
H
Coskun
Banu
B
Yilmaz
Seyhan
S
Alkan
Ugur
U
Cinar
Burhan
B
Dadas
D000818:Animals; D001672:Biocompatible Materials; D002483:Cellulose, Oxidized; D003094:Collagen / Q000378:metabolism; D005347:Fibroblasts / Q000187:drug effects / Q000473:pathology; D005355:Fibrosis / Q000473:pathology / Q000517:prevention & control; D006820:Hyaluronic Acid; D008297:Male; D008567:Membranes, Artificial; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013965:Thyroidectomy; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control
D001672:Biocompatible Materials; D002483:Cellulose, Oxidized; C060002:INTERCEED; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid; D003094:Collagen