Prevention of adhesions by Seprafilm, an absorbable adhesion barrier: an incisional hernia model in rats

Abstract

Adhesion formation, which is almost inevitable following incisional hernia repair with prosthetic mesh, may lead to intestinal obstruction and enterocutaneous fistulae. Physical barriers, namely carboxymethylcellulose and hyaluronic acid, have been reported to lessen the intra-abdominal adhesions. To evaluate the effects of Seprafilm (Genzyme Corp., Cambridge, MA), a bioresorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, in the presence of a foreign body such as polypropylene mesh, an incisional hernia model in rats was used. Twenty-four male rats were divided into two groups: control (12) and Seprafilm (12). A defect, measuring 1.5 x 2.5 cm, was created in each animal. Control animals had the polypropylene mesh sutured to the defect, whereas in the other group, two membranes of Seprafilm were laid over the abdominal viscera before repair with polypropylene mesh. Half of the animals from each group were killed at postoperative day 7 and remaining half at day 30 for adhesion scoring and histological evaluation of wound healing. Seprafilm animals had fewer adhesions compared with control animals (P = 0.0008). Seprafilm had no adverse effect on wound healing. This membrane seems to have the potential to lessen the adhesion-related morbidity following incisional hernia repair.