A direct comparison of seprafilm, adept, intercoat, and spraygel for adhesion prophylaxis.
BACKGROUND
Commercially available agents for adhesion prophylaxis are legion but there is a lack of direct comparisons between them. Here we compare four of the most commonly used adhesion barriers against a control group in a clinically relevant rat model.


METHODS
Standardized lesions were created in Wistar rats using electrocautery and suturing. Subsequently, the experimental lesions were treated with Seprafilm (n = 30), Adept (n = 30), Intercoat (n = 30), Spraygel (n = 30), or no barrier (n = 30). The resulting adhesions were examined 14 d postoperatively.


RESULTS
The mean area covered by adhesion was 77% in the control group, 46% in animals treated with Seprafilm, 54% in animals treated with Adept, 55% in animals treated with Intercoat, and 68% in animals treated with Spraygel. The adhesion-free incidence was 20% (n = 6) of lesions treated with Seprafilm, 20% (n = 6) of lesions treated with Intercoat, 3% of lesions treated with Spraygel (n = 1), and 0% of lesions treated with Adept or the control group.


CONCLUSIONS
There were statistically significant differences between the barriers with regards to the area covered by adhesions and the adhesion-free incidence. In spite of this, a significant adhesion burden remains with all of the tested barriers.
Rajab
Taufiek Konrad
TK
University of Tübingen, Tübingen, Germany. Taufiek.Rajab@imperial.ac.uk
Wallwiener
Markus
M
Planck
Constanze
C
Brochhausen
Christoph
C
Kraemer
Bernhard
B
Wallwiener
Christian Wilhelm
CW
D000818:Animals; D002425:Cautery / Q000379:methods*; D002448:Cell Adhesion / Q000187:drug effects; D005782:Gels; D005936:Glucans; D005947:Glucose; D006820:Hyaluronic Acid; D000077607:Icodextrin; D023421:Models, Animal; D051381:Rats; D017208:Rats, Wistar; D013537:Sutures; D000267:Tissue Adhesions / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000517:prevention & control
D005782:Gels; D005936:Glucans; C118198:Seprafilm; D000077607:Icodextrin; D006820:Hyaluronic Acid; D005947:Glucose