Evaluation of resorbable barriers for preventing surgical adhesions.

ABSTRACT

OBJECTIVE: To evaluate the ability of collagen film, collagen gel, sodium hyaluronate/carboxymethylcellulose film, and fibrin glue to prevent adhesion formation. DESIGN: Randomized trial using a rat model of a standardized abdominal wound and cecal wound. SETTING: University research laboratory. ANIMAL(S) Sprague-Dawley female rats. INTERVENTION(S) Resorbable barriers or no barrier (controls) were placed between an abdominal wall wound (1 cm x 2 cm) and a similarly sized cecal wound. MAIN OUTCOME MEASURE(S) Adhesion formation between wounds was assessed and quantitated 7 days after surgery. RESULT(S) Without treatment, 34 of 35 untreated rats (97%) developed adhesions. Treatment with collagen gel (3 of 33 rats), collagen film (3 of 10 rats), or sodium hyaluronate/carboxymethylcellulose film (2 of 10 rats) significantly reduced the incidence of adhesion formation. Treatment with fibrin sealant resulted in 9 of 10 animals having adherent wounds 7 days after surgery. CONCLUSION(S) Resorbable barriers of collagen gel, collagen films and sodium hyaluronate/carboxymethylcellulose film were effective in significantly reducing adhesion formation. Fibrin sealant at 7 days had an incidence of adhesion formation similar to that in untreated control animals.