title: Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model.
abstract: BACKGROUND
  Abdominal operations are followed by adhesions, a prevalent cause of abdominal pain, and the most frequent cause for bowel obstruction and secondary female infertility. This rat study addresses adhesion prevention capability of Adept(®), Interceed(®), Seprafilm(®), and a novel device, 4DryField(®) PH which is provided as powder and generates its effect as gel.
  
  
  METHODS
  Sixty-eight male Lewis rats had cecal abrasion and creation of an equally sized abdominal wall defect, and were grouped randomly: A control group without treatment (n=10); two groups treated with 4DryField(®) PH using premixed gel (n=15) or in-situ gel technique (n=16); one group each was treated with Seprafilm(®) (n=8), Interceed(®) (n=9), or Adept(®) (n=10). Sacrifice was on day 7 to evaluate incidence, quality, and quantity of adhesions, as expressed via adhesion reduction rate (AR). Histologic specimens were evaluated. Statistical analyses used ANOVA and unpaired t-tests.
  
  
  RESULTS
  4DryField(®) PH significantly reduced incidence and severity of adhesions both as premixed gel (AR: 85.2%) and as in-situ made gel (AR: 100%), a comparison between these two application techniques showed no differences in efficacy. Seprafilm(®) did not reduce incidence but severity of adhesions significantly (AR: 53.5%). With Interceed(®) (AR: 3.7%) and Adept(®) (AR: 16.1%) no significant adhesion-reduction was achieved. Except for inflammatory response with Interceed(®), histopathology showed good tissue compatibility of all other devices.
  
  
  CONCLUSIONS
  4DryField(®) PH and Seprafilm(®) showed significant adhesion prevention capabilities. 4DryField(®) PH achieved the highest adhesion prevention effectiveness without restrictions concerning mode of application and compatibility and, thus, is a promising strategy to prevent abdominal adhesions.
authors.affiliation: 1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
authors.forename: D
authors.initials: D
authors.lastname: Poehnert
authors.affiliation: 1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
authors.forename: L
authors.initials: L
authors.lastname: Grethe
authors.affiliation: 2. Institute of Pathology, Hannover Medical School, Germany;
authors.forename: L
authors.initials: L
authors.lastname: Maegel
authors.affiliation: 2. Institute of Pathology, Hannover Medical School, Germany;
authors.forename: D
authors.initials: D
authors.lastname: Jonigk
authors.affiliation: 2. Institute of Pathology, Hannover Medical School, Germany;
authors.forename: T
authors.initials: T
authors.lastname: Lippmann
authors.affiliation: 3. Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center-Transplantation (IFB-Tx), Hannover Medical School, Germany;; 4. Department of Trauma and Orthopaedic Surgery, Federal Armed Forces Hospital Westerstede, Westerstede, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kaltenborn
authors.affiliation: 1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;; 3. Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center-Transplantation (IFB-Tx), Hannover Medical School, Germany;
authors.forename: H
authors.initials: H
authors.lastname: Schrem
authors.affiliation: 1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
authors.forename: J
authors.initials: J
authors.lastname: Klempnauer
authors.affiliation: 1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
authors.forename: M
authors.initials: M
authors.lastname: Winny
mesh_terms: D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use; D006820:Hyaluronic Acid / Q000627:therapeutic use; D008297:Male; D008567:Membranes, Artificial; D010532:Peritoneal Diseases / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D011917:Rats, Inbred Lew; D000267:Tissue Adhesions / Q000517:prevention & control*
chemical_list: D008567:Membranes, Artificial; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium
keywords: 4DryField® PH; Adept®; Adhesion prevention; Interceed®; Seprafilm®; abdominal surgery; rat model OPAM