Seprafilm reduces adhesions to polypropylene mesh

Background. Adhesions to polypropylene mes used for abdominal wall hernia r epair may eventuate in intestinal obstruction or enterocutaneous fistula. A Seprafilm bioresorbable Membrane translucent adhesion barrier has been sho wn to inhibit adhesions. This investigation was designed to determine if Se prafilm alters abdominal visceral adhesions to polypropylene mesh. Methods. A 2.5-cm square abdominal muscle peritoneal defect was created and corrected wit polypropylene mesh. Mesh alone was used in 17 rats. In anoth er 17, the Seprafilm membrane was applied between the viscera and the mesh. five animals had the bioresorbable membrane placed in the subcutaneous spa ce and between the mesh and the viscera. laparoscopy was performed 7, 14, a nd 28 days later to evaluate adhesions as a percentage of mesh surface invo lved. Results. Polypropylene mesh alone was associated with adhesions in every ra t. The average area involved was 90%, the minimum was 75%. Adhesions were p resent within 24 hours and progressed up to 7 days with no change thereafte r. When the Seprafilm barrier was used, the mean area involved was 50%. In 16 such rats, the area involved was smaller than any control animal. No adh esions formed in 5 animals. Scanning electron microscopy demonstrated a mes othelial cell layer covering the mesh after 4 weeks. Conclusions. The use of the Seprafilm adhesion barrier resulted in a signif icant reduction of adhesion formation to polypropylene mesh (P < .001).