Seprafilm may ease colostomy reversal.
OBJECTIVE
In this study, we aimed to investigate whether the use of a sodium hyaluronate and carboxy-methylcellulose-based antiadhesive membrane (Seprafilm, Adhesion Barrier; Genzyme Corp, Cambridge, Mass) is associated with fewer adhesions around the pelvis and rectal pouch.


METHODS
Forty Wistar albino female rats were divided into 4 equal groups. Each rat underwent segmental left-sided colonic resection and end colostomy. The groups were as follows: group 1, colostomy alone (control group); group 2, colostomy and Seprafilm application around distal rectal pouch; group 3, colostomy and Seprafilm application beneath laparotomy incision; and group 4, colostomy and application of Seprafilm on both rectal pouch and laparotomy incision. All animals were operated on the 21st day and intra-abdominal adhesions were evaluated.


RESULTS
The results were assessed by analysis of variance and Tukey multiple comparison tests. Intra-abdominal adhesions were significantly (P<.05) reduced in groups 2 through 4 compared with the control group, whereas no statistically significant difference was observed between these 3 groups.


CONCLUSIONS
The use of Seprafilm during the initial step of the Hartmann colostomy reduced intra-abdominal adhesions on the reversal. This result might be beneficial in the prevention of adhesion-related difficulties during second operation and its application beneath laparotomy incision seems to be sufficient to ensure this effect.
Saribeyoğlu
Kaya
K
Department of Surgery, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey.
Pekmezci
Salih
S
Ulualp
Kenan
K
D000818:Animals; D001672:Biocompatible Materials; D002266:Carboxymethylcellulose Sodium; D003125:Colostomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006820:Hyaluronic Acid; D008567:Membranes, Artificial; D010388:Pelvis; D011183:Postoperative Complications; D051381:Rats; D017208:Rats, Wistar; D012086:Reoperation; D000267:Tissue Adhesions / Q000517:prevention & control
D001672:Biocompatible Materials; D008567:Membranes, Artificial; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium