Adhesion Reformation: Reduction by the Use of Interceed (TC7) Plus Heparin

Abstract

Adhesions frequently develop after surgical procedures. Several groups have demonstrated that reduction of adhesion reformation is more difficult than reduction of adhesion formation. Previous studies have demonstrated the efficacy of Interceed (TC7) (oxidized regenerated cellulose) plus heparin in reducing adhesion formation. Adhesions were created using a previously standardized rabbit uterine horn model. After adhesiolysis, rabbits were assigned randomly to one of four groups: control, Interceed (TC7) alone, Interceed (TC7) plus 500 USP units heparin/horn, and Interceed (TC7) plus 1000 USP units heparin/horn. Adhesion reformation was evaluated 2 weeks later. Combination of the Interceed (TC7) barrier plus heparin resulted in a significant reduction of the adhesion reformation scores. It is concluded that Interceed (TC7) plus heparin is efficacious in reduction of both adhesion formation and adhesion reformation.

Ultrapure alginate gel reduces adhesion reformation after adhesiolysis

“…This apparent disparity between reduction of adhesion formation and adhesion reformation has also been reported with other anti-adhesive barriers in both clinical and animal studies. Oxidized regenerated cellulose (Interceed®) was less effective in preventing adhesion reformation rates than de novo adhesion formation and did not reduce adhesion reformation scores [18]. Animal studies with other barriers like polytetrafluoroethylene (PTFE; GoreTex®), chemically cross-linked hyaluronic acid (Incerf®), and polyethylene oxide and carboxymethylcellulose (Oxiplex®) showed similar outcomes [19][20][21].…”

“…Animal studies with other barriers like polytetrafluoroethylene (PTFE; GoreTex®), chemically cross-linked hyaluronic acid (Incerf®), and polyethylene oxide and carboxymethylcellulose (Oxiplex®) showed similar outcomes [19][20][21]. The relative ischemia of adhesions and increased production of inflammatory cytokines after lysis resulting in a prolonged healing of peritoneal tissue are conditions that may explain the lower efficacy in preventing adhesion reformation [18,22,23]. Persistent inflammatory activity at the wound site and delayed healing may result in adhesion formation at the time that a bioresorbable adhesion barrier has been dissolved.…”

Sıçan uterin horn modelinde enoksaparin ve rapamisinin adezyon oluşumuna etkilerinin karşılaştırılması

“…Bu durum diğer çalışma grupları için de geçerlidir. DMAH'lerin adezyon yaygınlığını azalttığına dair araştırmalar bulunmaktadır [15,16]. Bu çalışmalardaki bulgular bizim sonuçlarımızla paralellik göstermektedir.…”

A prospective, controlled, randomized, multicenter, exploratory pilot study evaluating the safety and potential trends in efficacy of Adhexil

“…Although the compositions of these synthetic products are all different (Interceed is a fabric composed of oxidized regenerated cellulose, Seprafilm is a film composed of modified hyaluronic acid and carboxymethylcellulose, and Adept is an icodextrin solution that disperses throughout the abdominopelvic cavity), they all have in common that their reported primary mode of action is as a barrier (5,18). As a barrier, they are thought to work by separating the surgically (or pathologically) injured tissue from other tissue surfaces during the initial postoperative time period while remesotheliazation is occurring, a process that is thought to usually take 3-5 days (5,16,19,20). Adept is the only product designed to be used in laparoscopic surgery; its reported efficacy is a 9.8% reduction in incidence compared with control (3,21,22).…”