Safety and long-term outcome of a new concept for surgical adhesion-reduction strategies (Prevadh): a prospective, multicenter study.
OBJECTIVE
No agent has been consistently effective in preventing formation of peritoneal adhesions and postoperative bowel obstruction after abdominal surgery. The aim of this prospective multicenter study was to assess clinical safety and efficiency of a new adhesion-reduction barrier


METHODS
Between September 2000 and April 2001, Prevadh was used in 78 patients. Operative procedures included 25 hepatic resections, 7 cholecystectomies, 32 colonic resections, 7 protectomies, 3 colostomy or recovery of continuity, 1 gynaecologic surgery and 3 others. Eleven patients were operated on by laparoscopy and 67 by laparotomy.


RESULTS
The overall incidence of abscesses and wound complications was 2.4% and 9% respectively. After a mean follow-up of 36 months (range: 4-51 months), no patients experienced adverse events related to the adhesion barrier. Surgical reoperative procedures were performed in 10 patients for unrelated causes and no bowel obstruction occurred within the protected area.


CONCLUSIONS
This study confirmed the safety of Prevadh adhesion barrier and suggested that this resorbable barrier might provide prevention from adhesion formation on peritoneal injured surfaces. However, a large randomized controlled trial remains necessary to prove the real effectiveness of adhesion barriers on clinical long-term outcome.
Mabrut
Jean-Yves
JY
Hôpital de la Croix-Rousse, Lyon, France.
Favre
Jean-Pierre
JP
Desrousseaux
Bruno
B
Chipponi
Jacques
J
Arnaud
Jean-Pierre
JP
Domergue
Jacques
J
Duffas
J P
JP
Fourtanier
Gilles
G
Flament
Jean-Bernard
JB
Gouillat
Christian
C
Berdah
Stéphane
S
Mantion
Georges
G
Fagniez
Pierre-Louis
PL
Champault
Gérard
G
Baulieux
Jacques
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D000267:Tissue Adhesions / Q000517:prevention & control*; D016896:Treatment Outcome
D001672:Biocompatible Materials