Abstract
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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Article info
Publication history
Accepted:
February 27,
2000
Footnotes
*Supported by grants from the Genzyme Corporation.
**Reprint requests: John P. Delaney, MD, PhD, University of Minnesota, Health Sciences Center, Box 89, 420 Delaware St, SE, Minneapolis, MN 55455.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
