A sprayable hydrogel adhesion barrier facilitates closure of defunctioning loop ileostomy: a randomized trial.
Dis Colon Rectum
; 51(6): 956-60, 2008 Jun.
Article
in En
| MEDLINE
| ID: mdl-18219530
ABSTRACT
PURPOSE:
Closure of defunctioning loop ileostomy often is associated with division of complex peristomal adhesions through a parastomal incision with limited exposure. The goal was to determine whether sprayable hydrogel adhesion barrier (SprayGel) will reduce peristomal adhesions and facilitate closure of ileostomy.METHODS:
Patients undergoing closure of loop ileostomy were randomized to have hydrogel adhesion barrier sprayed around both limbs of ileostomy for 20 cm (SprayGel group, n = 19), or to control without adhesion barrier (control group, n = 21). Ileostomy was reversed at ten weeks after construction. Extent of peristomal adhesions was scored in blinded manner (each quadrant, range, 1-3 3 = most severe; total, range, 4-12 12 = most severe).RESULTS:
Use of adhesion barrier was associated with significant reduction in overall adhesion scores (mean, 6.11 vs. 9.67; P < 0.0005), four-quadrant adhesion scores (Quadrant A 1.68 vs. 2.52, P = 0.002; Quadrant B 1.42 vs. 2.33, P < 0.0005; Quadrant C 1.42 vs. 2.24, P < 0.0005; Quadrant D 1.58 vs. 2.48, P = 0.002), and proportion of patients with dense (scores > or = 8) adhesions (0.11 vs. 0.71; P < 0.0005). Time taken to mobilize (16.53 vs. 21.67 minutes; P = 0.008) and close ileostomy (35.37 vs. 41.90 minutes; P = 0.008) was significantly reduced. Postoperative complications were comparable.CONCLUSIONS:
A sprayable hydrogel adhesion barrier placed around the limbs of a defunctioning loop ileostomy reduced peristomal adhesions and might facilitate closure of ileostomy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Ileostomy
/
Tissue Adhesions
/
Adhesives
/
Hydrogels
/
Aerosols
Type of study:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Dis Colon Rectum
Year:
2008
Document type:
Article
Affiliation country:
Australia