Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Winter;2(1):38-45.

Preventing adhesions in obstetric and gynecologic surgical procedures

Víctor Hugo González-Quintero  1 , Francisco E Cruz-Pachano
Affiliations

Preventing adhesions in obstetric and gynecologic surgical procedures

Víctor Hugo González-Quintero et al. Rev Obstet Gynecol. 2009 Winter.

Abstract

Adhesive disease represents a significant cause of morbidity for postoperative patients. Most surgical procedures performed by obstetrician-gynecologists are associated with pelvic adhesions that cause subsequent serious sequelae, including small bowel obstruction, infertility, chronic pelvic pain, and difficulty in postoperative treatment, including complexity during subsequent surgical procedures. The technology of adhesion prevention has significantly progressed. There are 3 methods approved by the US Food and Drug Administration for the prevention of postoperative adhesions, including Adept((R)), Interceed((R)), and Seprafilm((R)). The latter barrier is the most widely studied. This article reviews the current choices available for adhesion prevention barriers as well as surgical adjuncts that traditionally have been studied for that purpose.

Keywords: Adhesion prevention; Cesarean deliveries; Gynecological surgeries; Postoperative morbidity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Different stages of the wound healing process. Full-thickness excisional mouse wounds are shown at (a) day 1 (inflammatory phase), (b) day 5 (phase of new tissue formation), and (c) day 14 (phase of tissue remodeling). The different components of the healing skin wounds are indicated. C, clot; D, dermis; E, epidermis; ES, eschar; F, fatty tissue; G, granulation tissue; HE, hyperproliferative epithelium; HF, hair follicle; M, muscle; RE, regenerating epithelium; G/S, late granulation tissue/ early scar tissue. Reprinted, with permission, from Annual Review of Cell and Developmental Biology, Volume 23, © 2007 by Annual Reviews. www.annualreviews.org.
Figure 2
Figure 2
Incidence of adhesions at first repeat cesarean delivery.
Figure 3
Figure 3
Delayed infant delivery and number of cesarean deliveries. Reprinted with permission from Morales KJ et al.
Figure 4
Figure 4
The application of Seprafilm® (Genzyme Corporation, Cambridge, MA) during cesarean delivery.
See this image and copyright information in PMC

References

    1. DeCherney AH, diZerega GS. Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers. Surg Clin North Am. 1997;77:671–688. - PubMed
    1. Davey AK, Maher PJ. Surgical adhesions: a timely update, a great challenge for the future. J Minim Invasive Gynecol. 2007;14:15–22. - PubMed
    1. Menzies D. Peritoneal adhesions. Incidence, cause, and prevention. Surg Annu. 1992;24:27–45. - PubMed
    1. MacLean AR, Cohen Z, MacRae HM, et al. Risk of small bowel obstruction after the ileal pouch-anal anastomosis. Ann Surg. 2002;235:200–206. - PMC - PubMed
    1. Beck DE, Opelka FG, Bailey HR, et al. Incidence of small-bowel obstruction and adhesiolysis after open colorectal and general surgery [erratum in Dis Colon Rectum. 1999;42:578] Dis Colon Rectum. 1999;42:241–248. - PubMed

LinkOut - more resources