Human Reproduction, Vol. 16, No. 12, 2718-2723,
December 2001
© 2001 European Society of Human Reproduction and Embryology
Evaluation of a sprayable polyethylene glycol adhesion barrier in a porcine efficacy model
1 Women and Infants Hospital, Providence, RI 02905 and 2 Confluent Surgical Inc., 101A First Avenue, Waltham, MA 02451, USA
BACKGROUND: The formation of adhesions following pelvic surgery remains one of the leading causes of infertility, small bowel obstruction and re-operation for pelvic pain. A novel hydrophilic polyethylene glycol based adhesion barrier (SprayGel) is formed by simultaneously spraying two liquid precursors onto surgical sites. The liquids polymerize to form a gel that effectively coats and adheres to tissue. After about 5 days, the hydrogel layer is absorbed and subsequently undergoes renal clearance. It is believed that the presence of such a barrier would inhibit the formation of adhesions following surgical insult. METHODS: A porcine adhesion model was developed wherein bilateral uterine horn transection and re-anastomosis, along with peritoneal side wall excision was performed via laparotomy. In each animal (n = 10, including the pilot study) one pelvic side wall was treated with adhesion barrier, while the contralateral side remained untreated. RESULTS: At second look laparoscopy, 90% of the untreated sites had adhesions, compared with 30% of the treated sites (P = 0.006). Also observed were statistically significant reductions in the adhesion extent (P = 0.029) and adhesion severity scores (P = 0.023) at the treated sites. However, if the pilot study was excluded (n = 8) the differences obtained were no longer significant. CONCLUSIONS: Polyethylene glycol (SprayGel) merits further investigation as an effective barrier to the formation of post-operative adhesions in this porcine model.
Key words: adhesion prevention/post-surgical adhesions/large animal models/laparoscopy/adhesion barriers
3 To whom correspondence should be addressed at: 695 Eddy St., Providence, RI 02905, USA. E-mail: roger_ferland{at}brown.edu
Statement of commercial interest
D.Mulani is a former employee while P.K.Campbell is a current employee of Confluent Surgical Inc. R.Ferland is a consultant to Confluent Surgical Inc.
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