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Human Reproduction, Vol. 15, No. 6, 1358-1363, June 2000
© 2000 European Society of Human Reproduction and Embryology

Effects of five different barrier materials on postsurgical adhesion formation in the rat

B.W.J. Hellebrekers1,3, G.C.M. Trimbos-Kemper1, C.A. van Blitterswijk2, E.A. Bakkum1 and J.B.M.Z. Trimbos1

1 Department of Gynecology, Leiden University Medical Center, and 2 Biomaterials Research Group, Leiden University, The Netherlands

Postsurgical adhesion formation is a significant clinical problem within every surgical specialism. Due to the problems that adhesions cause, a wide variety of adjunctive treatments to prevent the formation and reformation of adhesions have been proposed. One of the modalities that has been studied extensively and that has been showing the most promising results is the so-called barrier method. The purpose of the present study was to compare the efficacy of five of these barrier materials in the prevention of postsurgical adhesion formation in a standardized rat adhesion model. It was concluded that no beneficial effect of Ringer's lactate on adhesion formation was seen. Significant reductions (P < 0.0001) in adhesion percentages compared to control animals were seen with PolyactiveTM, PRECLUDE Peritoneal MembraneTM, SeprafilmTM and TissucolTM, but only PRECLUDE Peritoneal Membrane and Seprafilm significantly reduced adhesions (P < 0.01) when the barrier-treated peritoneal defects were compared with contralateral control-side peritoneal defects. The results of our study suggest that Seprafilm and PRECLUDE Peritoneal Membrane are superior to Tissucol and Polyactive in preventing adhesion formation. When Polyactive was still attached to the site of application during the second laparotomy, similar results to Seprafilm and PRECLUDE Peritoneal Membrane were seen. Future studies on the efficacy of a material to decrease adhesion formation should always include a comparison of several control materials in the same model. Our study indicates that Seprafilm or PRECLUDE Peritoneal Membrane might be used as standards of control.

Key words: adhesions/comparative study/prevention/rat model

3 To whom correspondence should be addressed at: Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: bwjh{at}xs4all.nl


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