title: A sprayable hyaluronate/carboxymethylcellulose adhesion barrier exhibits regional adhesion reduction efficacy and does not impair intestinal healing.
abstract: BACKGROUND
  While bioresorbable solid barriers such as Seprafilm® prevent adhesions, their efficacy is limited to sites of application. The aim of this study was to assess the effectiveness of the sprayable adhesion barrier Sepraspray® in preventing adhesions to sites of direct application and to remote sites.
  
  
  METHODS
  Intraabdominal adhesions were induced in 30 rats by creating three ischemic buttons on each side of a midline incision. To assess efficacy, Sepraspray (5 mg/button) or Seprafilm (1 cm(2)/button) was applied over three buttons on one side of the peritoneum. Operated control animals received no treatment. On day 7, adhesions were scored as percent of buttons with adhesions. To assess safety, 81 rats underwent a colonic transection repaired with an end-to-end anastomosis. Both barriers were applied circumferentially to anastomoses. Controls received no product. The integrity of healing anastomosed colonic wounds was assessed by burst pressure and tensile strength at days 3, 5, and 7 postoperatively.
  
  
  RESULTS
  The direct application of both Sepraspray and Seprafilm significantly (p < 0.001) reduced adhesion formation compared to controls. While Seprafilm had no remote effect on adhesion formation, Sepraspray significantly (p < 0.001) reduced adhesion formation to contralateral ischemic buttons. Neither barrier affected anastomotic integrity at any time point.
  
  
  CONCLUSIONS
  Sepraspray has widespread efficacy throughout the peritoneum in reducing adhesions without compromising intestinal healing. Furthermore, this sprayable alternative offers the potential for easier intraabdominal application.
authors: Department of Surgery, Boston University Medical Center, 88 East Newton Street, C-500, Boston, MA 02118, USA.
authors: Holly K
authors: HK
authors: Sheldon
authors: Melanie L
authors: ML
authors: Gainsbury
authors: Michael R
authors: MR
authors: Cassidy
authors: Daniel I
authors: DI
authors: Chu
authors: Arthur F
authors: AF
authors: Stucchi
authors: James M
authors: JM
authors: Becker
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000209:etiology / Q000517:prevention & control*; D004337:Drug Carriers; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008567:Membranes, Artificial; D010532:Peritoneal Diseases / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011208:Powders; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D004337:Drug Carriers; D008567:Membranes, Artificial; D011208:Powders; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium