Original Communications| Volume 128, ISSUE 1, P86-92, July 2000

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Seprafilm reduces adhesions to polypropylene mesh


      Background. Adhesions to polypropylene mesh used for abdominal wall hernia repair may eventuate in intestinal obstruction or enterocutaneous fistula. A Seprafilm Bioresorbable Membrane translucent adhesion barrier has been shown to inhibit adhesions. This investigation was designed to determine if Seprafilm alters abdominal visceral adhesions to polypropylene mesh. Methods. A 2.5-cm square abdominal muscle peritoneal defect was created and corrected with polypropylene mesh. Mesh alone was used in 17 rats. In another 17, the Seprafilm membrane was applied between the viscera and the mesh. Five animals had the bioresorbable membrane placed in the subcutaneous space and between the mesh and the viscera. Laparoscopy was performed 7, 14, and 28 days later to evaluate adhesions as a percentage of mesh surface involved. Results. Polypropylene mesh alone was associated with adhesions in every rat. The average area involved was 90%, the minimum was 75%. Adhesions were present within 24 hours and progressed up to 7 days with no change thereafter. When the Seprafilm barrier was used, the mean area involved was 50%. In 16 such rats, the area involved was smaller than any control animal. No adhesions formed in 5 animals. Scanning electron microscopy demonstrated a mesothelial cell layer covering the mesh after 4 weeks. Conclusions. The use of the Seprafilm adhesion barrier resulted in a significant reduction of adhesion formation to polypropylene mesh (P <.001). (Surgery 2000;128:86-92)
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        • Mudge M
        • Hughes LE
        Incisional hernia: A 10-year prospective study of incidence and attitudes.
        Br J Surg. 1985; 72: 70-71
        • Bendavid R
        The need for mesh.
        in: Prostheses and abdominal wall hernias. : R.G. Landes Company, Austin (Texas)1994: 116-122
        • Karakousis C
        • Volpe C
        • Tanski J
        • Colby E
        • Winston J
        • Driscoll D.
        Use of a mesh for musculoaponeurotic defects of the abdominal wall in cancer surgery and the risk of bowel fistulas.
        J Am Coll Surg. 1995; 181: 11-16
        • Kaufman Z
        • Engelberg M
        • Zager M.
        Fecal fistula: a late complication of Marlex mesh repair.
        Dis Colon Rectum. 1981; 24: 543-544
        • Stone HH
        • Fabian TC
        • Turkleson ML
        • Jurkiewicz MJ
        Management of acute full-thickness losses of abdominal wall.
        Ann Surg. 1981; 193: 612-618
        • Becker JM
        • Dayton MT
        • Fazio VW
        • Beck DE
        • Stryker SJ
        • Wexner SD
        • et al.
        Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane. A prospective, randomized, double-blind multicenter study.
        J Am Coll Surg. 1996; 183: 297-306
        • Diamond MP
        Reduction of adhesions after uterine myomectomy by Seprafilm membrane (HAL-F): A blinded, prospective, randomized multicenter clinical study.
        Fertil Steril. 1996; 66: 904-910
        • De Iaco PA
        • Stefanetti M
        • Pressato D
        • Piana S
        • Dona M
        • Pavesio A
        • et al.
        A novel hyaluronate-based gel in laparoscopic adhesion prevention: preclinical evaluation in an animal model.
        Fertil Steril. 1998; 69: 318-323
        • Urman B
        • Gomel V
        • Jetha N.
        Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model.
        Fertil Steril. 1991; 56: 563-567
        • Johns DB
        • Rodgers KE
        • Donahue WD
        • Kiorpes TC
        • Dizerega GS
        Reduction of adhesion formation by postoperative administration of ionically cross-linked hyaluronic acid.
        Fertil Steril. 1997; 68: 37-42
        • Alponat A
        • Lakshminarasappa SR
        • Yavuz N
        • Goh PMY
        Prevention of adhesions by Seprafilm, an absorbable adhesion barrier: an incisional hernia model in rats.
        Am Surg. 1997; 63: 818-819
        • Junqueira LCU
        • Bignolas G
        • Brentani RR
        A simple and sensitive method for the quantitative estimation of collagen.
        Anal Biochem. 1979; 94: 96-99
        • Burns JW
        • Colt J
        • Burgess LS
        • Skinner KC
        Preclinical evaluation of Seprafilm¿ bioresorbable membrane.
        Eur J Surg. 1997; 577: 40-48
        • Raftery AT
        Regeneration of parietal and visceral peritoneum: an electron microscopical study.
        J Anat. 1973; 115: 375-392
        • Operative Laparoscopy Study Group
        Postoperative adhesion development after operative laparoscopy: evaluation at early second-look procedures.
        Fertil Steril. 1991; 55: 700-704
        • van Hinsberg VWM
        • Kooistra T
        • Scheffer MA
        • Hajo van Bockel J
        • van Muijen GN
        Characterization and fibrinolytic properties of human omental tissue mesothelial cells. Comparison with endothelial cells.
        Blood. 1990; 7: 1490-1497