Preventing intra-abdominal adhesions with polylactic acid film: an animal study.
OBJECTIVE
The aim of this study was to evaluate the efficacy of an absorbable polylactic acid film (SurgiWrap) in preventing postoperative intra-abdominal adhesions in an animal model.


METHODS
Forty-four female Sprague-Dawley rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. Rats were divided equally between untreated and treated groups. Treated rats had a polylactic acid film (SurgiWrap) placed between the cecal and abdominal wall defects. Rats in the untreated group received no barrier material. The animals were killed on postoperative day 21. Two blinded observers, using predetermined criteria, graded the cecum-to-abdominal wall adhesions and estimated the percent of cecal surface area involved in the adhesion. The adhesions were classified as absent, moderate, or severe.


RESULTS
Four rats died postoperatively. Of surviving rats, all of the rats in the untreated group had cecum-to-abdominal wall adhesions, whereas 42.1 percent of rats in the treated group had no adhesions between the cecum and the abdominal wall (two-tailed, P = 0.001). Altogether, 28.6 percent and 71.4 percent of untreated rats experienced moderate and severe adhesions, respectively, compared to 47.4 percent and 10.5 percent of treated rats (two-tailed, P < 0.001).


CONCLUSIONS
Strategic placement of polylactic acid film during abdominal surgery is associated with a significantly reduced rate and severity of postoperative intra-abdominal adhesions in this model. A technique for film placement is suggested.
Avital
Shmuel
S
Division of Colon and Rectal Surgery, Department of Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA.
Bollinger
Thomas J
TJ
Wilkinson
James D
JD
Marchetti
Floriano
F
Hellinger
Michael D
MD
Sands
Laurence R
LR
D000005:Abdomen / Q000473:pathology*; D000818:Animals; D001672:Biocompatible Materials; D002432:Cecum / Q000473:pathology*; D004195:Disease Models, Animal; D005260:Female; D019344:Lactic Acid / Q000627:therapeutic use*; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000267:Tissue Adhesions / Q000517:prevention & control*
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)