A safety and efficacy study of a resorbable hydrogel for reduction of post-operative adhesions following myomectomy.
BACKGROUND
This multicenter, randomized, single-blind study assessed the safety and efficacy of a resorbable hydrogel ('Hydrogel') for the reduction of post-operative adhesion formation following myomectomy.


METHODS
Women (n = 71) who were undergoing laparoscopic (67.6%) or laparotomic myomectomy were randomized (2:1) to Hydrogel (sprayed over surgically treated areas prior to wound closure, n = 48) or to control (standard care, n = 23). Patients (38 Hydrogel, 20 control) returned 8-10 weeks later for a second look. Adhesions were graded using a modified American Fertility Society (mAFS) scoring method. The primary efficacy measure was the posterior uterus mAFS score.


RESULTS
For Hydrogel and control patients, respectively, mean +/- SD mAFS scores were 0.5 +/- 1.4 and 0.0 +/- 0.0 at baseline, and 1.1 +/- 1.9 and 2.6 +/- 2.2 at the second look. Similarly, mean changes from baseline were 0.8 +/- 2.0 and 2.6 +/- 2.2 (P = 0.01); 95% confidence intervals for these mean changes were (0.16-1.44) and (1.64-3.56). Adverse events were reported by 9.6 and 17.4% of Hydrogel and control patients, respectively. No intra-abdominal infections or post-operative site infections were reported.


CONCLUSIONS
This 71-patient study provides the first clinical evidence of the safety and efficacy of Hydrogel for the reduction of adhesions following myomectomy. The ClinicalTrials.gov Identifier is NCT00562471.
Mettler
L
L
Department of Obstetrics and Gynecology, University Clinics of Schleswig-Holstein, Campus Kiel, Michaelisstrasse 16, 24105 Kiel, Germany. endo-office@email.uni-kiel.de
Hucke
J
J
Bojahr
B
B
Tinneberg
H-R
HR
Leyland
N
N
Avelar
R
R
D000328:Adult; D005260:Female; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use*; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D012449:Safety; D016037:Single-Blind Method; D000267:Tissue Adhesions / Q000517:prevention & control*; D014594:Uterine Neoplasms / Q000601:surgery
C513322:CoSeal; D020100:Hydrogels; D011092:Polyethylene Glycols