PREVENTION OF ADHESIONS BY SEPRAFILM, AN ABSORBABLE ADHESION BARRIER - AN INCISIONAL HERNIA MODEL IN RATS

Adhesion formation, which is almost inevitable following incisional he rnia repair with prosthetic mesh, may lead to intestinal obstruction a nd enterocutaneous fistulae. Physical barriers, namely carboxymethylce llulose and hyaluronic acid, have been reported to lessen the intra-ab dominal adhesions. To evaluate the effects of Seprafilm (Genzyme Corp. , Cambridge, MA), a bioresorbable, translucent membrane composed of ca rboxymethylcellulose and hyaluronic acid, in the presence of a foreign body such as polypropylene mesh, an incisional hernia model in rats w as 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 wer e laid over the abdominal viscera before repair with polypropylene mes h. Half of the animals from each group were killed at postoperative da y 7 and remaining half at day 30 for adhesion scoring and histological evaluation of wound healing. Seprafilm animals had fewer adhesions co mpared with central animals (P = 0.0008). Seprafilm had no adverse eff ect on wound healing, This membrane seems to have the potential to les sen the adhesion-related morbidity following incisional hernia repair.