Effects of seprafilm on peritoneal fibrinolytic system.
BACKGROUND
There is a high incidence of adhesions after ventral hernia repair with polypropylene mesh. The purpose of the present study was to evaluate the efficacy of Seprafilm in the prevention of adhesion formation and effect on peritoneal fibrinolytic activity.


METHODS
An incisional hernia model was created in rats. In the experimental group Seprafilm was placed between polypropylene mesh and abdominal organs. On the 14th day adhesions were evaluated and tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), plasminogen activator inhibitor (PAI) type 1 and 2 were measured in peritoneal biopsy specimens.


RESULTS
Adhesions were significantly reduced in the Seprafilm group (P = 0.002). Nevertheless, there were no difference between the two groups in levels of tPA, PAI-1 and PAI-2. However, the levels of uPA were significantly decreased in the Seprafilm group.


CONCLUSIONS
The adhesion preventive effect of Seprafilm is not directly related in peritoneal fibrinolytic activity. Instead, the physical properties (barrier, hydroflotation and sliconizing effect) of the membrane are primarily responsible for adhesion prevention.
Tarhan
Omer Ridvan
OR
Süleyman Demirel University Medical School, Isparta, Turkey. drtarhan@yahoo.com
Eroglu
Aydan
A
Cetin
Recep
R
Y Nce
Ayper
A
Bulbul
Mahmut
M
Altuntas
Y Rfan
YR
D034861:Abdominal Wall / Q000601:surgery; D000818:Animals; D002266:Carboxymethylcellulose Sodium; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000494:pharmacology; D008567:Membranes, Artificial; D010532:Peritoneal Diseases / Q000517:prevention & control*; D010537:Peritoneum / Q000378:metabolism*; D015849:Plasminogen Inactivators / Q000378:metabolism; D011126:Polypropylenes; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000517:prevention & control; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D014568:Urokinase-Type Plasminogen Activator / Q000378:metabolism
D008567:Membranes, Artificial; D015849:Plasminogen Inactivators; D011126:Polypropylenes; C118198:Seprafilm; D006820:Hyaluronic Acid; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; D002266:Carboxymethylcellulose Sodium