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Int J Med Sci. 2016 Jun 30;13(7):524-32. doi: 10.7150/ijms.15167. eCollection 2016.

Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model.

Author information

1
1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
2
2. Institute of Pathology, Hannover Medical School, Germany;
3
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.
4
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;

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.

CONCLUSION:

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.

KEYWORDS:

4DryField® PH; Adept®; Adhesion prevention; Interceed®; Seprafilm®; abdominal surgery; rat model OPAM

PMID:
27429589
PMCID:
PMC4946123
DOI:
10.7150/ijms.15167
[Indexed for MEDLINE]
Free PMC Article

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