Preventing Intra-Abdominal Adhesions With Polylactic Acid Film: An Animal Study

Abstract

Strategic placement of polylactic acid film during abdominal surgery is associated with a significantly reduced rate and severity of postoperative intra-abdominal adhesions in this model. A technique for film placement is suggested.

Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

“…The heavy adhesions (score 3, 4) in 22.2% (Figs. 1 and 3) of the rats in the PLA group indicates that PLA may induce adhesions and related complications especially when an increased risk for adhesions exists as in [14,16,17]. However, Duffy et al reported that absorbable polylactic acid and metal tacks resulted in equivalent adhesion formation [18].…”

“…However the fixation materials may form visceral adhesions even if no prosthetic mesh graft is in the abdomen. Many cases of staples left inadvertently in the abdomen have been noted for a long time, causing severe abdominal adhesions [7,9,11,14]. While secure fixation is a desired property of the fixation material, adhesions are not [9].…”

Bioresorbable film for the prevention of adhesion to the anterior spine after anterolateral discectomy

“…Fibrosis, which can lead to adhesions between healing tissues, is a problem that is seen in a wide array of surgical specialties. Adhesions that form postoperatively have been associated with "failed back syndrome," bowel obstruction, chronic pain, and infertility [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25] . In addition, subsequent surgeries are made more challenging and can lead to organ injury because of attachment between structures that are usually independent of one another.…”

“…Extensive research has been conducted into the mechanism of adhesion formation. It is believed that after surgery there is a decreased concentration and activity of fibrinolytic activity, resulting in deposition of fibrin matrix on which organized collagen, and thus, scar formation can occur [1], [2], [3], [6], [7], [8], [11], [14], [15], [20], [23], [26], [27] . Because of the morbidity associated with unwanted or excessive adhesion between tissues, multiple strategies have been used and studied to prevent adhesion formation.…”

“…Most of these studies have shown that this bioresorbable film is efficacious in minimizing adhesion after various procedures including hemisternotomy and pericardiumotomy, pelvic surgery, spinal laminectomy, abdominal surgery, and bowel anastomosis surgery [2], [9], [22], [64], [65] . Most recently, a study of Hydrosorb Shield revealed its efficacy as a barrier to adhesion between the paraspinal musculature and dura mater of the spinal cord in sheep without inhibiting healing of an iatrogenically induced dural tear with cerebrospinal fluid leakage [46] .…”