Effect of Polylactic Acid Film Barrier on Intra-Abdominal Adhesion Formation

Abdominal Adhesions: Current and Novel Therapies

“…Some efficacy in rat model [126][127][128][129] Efficacy comparable to Seprafilm in rat model but induced significantly less inflammation [128] No efficacy in pigs [130] D,L-polylactide-epsilon-caprolactonetrimethylenecarbonate Some efficacy in rat model [131] Investigators laparoscopic compatibility [131] Some efficacy in rat and rabbit models [38, [132][133][134][135][136] No efficacy in rabbit model [137,138] Some efficacy in humans, but not statistically significant [139] One randomized, controlled trial in humans supports use versus Ringer's lactate solution; 4% icodextrin reduced the number of visceral adhesion but did not reduce the extent and severity of adhesions [140] Efficacy superior to Seprafilm in rat model; also, increased hydroxyproline levels and intestinal bursting pressures [78] Efficacy inferior to Seprafilm in rat model [136] Enhanced adhesion and abscess formation in rat peritonitis model [141] Activated systemic and peritoneal inflammation in humans [142] Approved in Europe and recently approved by FDA [104, 143] Ringer's lactate solution Some efficacy in rat model [135] No efficacy in rabbit [138] Some efficacy in reducing adhesion incidence and severity in human females undergoing myomectomy (n ¼ 52) [158] Some reduction in adhesion formation in mouse and rat models [38, 159,160]; [124] Contradictory efficacy in animal models [43,161] Only efficacious if administered before tissue injury and may not persist long enough to prevent adhesion formation in humans [1, 33] A chemically modified hyaluronate derivative that can be used as an injectable hydrogel [125] 0.5% Ferric hyaluronate gel (Intergel)…”

An Assessment of the Effects of a Hyaluronan-Based Solution on Reduction of Postsurgical Adhesion Formation in Rats: A Comparative Study of Hyaluronan-Based Solution and Two Film Barriers

“…Until now, a method that has been studied extensively and that has shown the most promising results is to place a biocompatible film barrier between the viscera and peritoneum. This manufactured biomaterial works as an isolator between the damaged surface in the critical process of adhesion formation [5]. During the last decades, a number of film barriers, such as Interceed (oxidized regenerated cellulose), PRECLUDE Peritoneal Membrane (expanded polytetrafluoroethylene), SurgiWrap (polylactic acid film), and Seprafilm (sodium hyaluronate and carboxymethylcellulose membrane) have become commercially available to surgeons wishing to prevent formation of adhesion.…”

Preventing postoperative abdominal adhesions in a rat model with PEG-PCL-PEG hydrogel

“…24 Briefly, the rats were anesthetized by ketamine hydrochloride (60 mg/kg bodyweight) and were placed in the supine position, shaved in the abdominal area, prepared with iodine solution and ethanol, and then draped in a sterile fashion. An anterior midline incision was made through the abdominal wall and peritoneum.…”

“…The incision was closed in two layers with 3/0 surgical silk suture. On day 15, the animals were sacrificed, and the adhesion formation was evaluated according to the widely used standard adhesion scoring system as follows: [24][25][26] score 0, no adhesion; score 1, one thin filmy adhesion; score 2, definite localized adhesions; score 3, dense multiple visceral adhesions; score 4, dense adhesions extending abdominal wall. The scoring was determined by two observers in a blinded manner.…”