Development and Clinical Evaluation of Intergel Adhesion Prevention Solution for the Reduction of Adhesions Following Peritoneal Cavity Surgery

  • Douglas B. Johns
  • Gere S. DiZerega
Chapter

Abstract

Adhesion formation after peritoneal surgery is a major cause of postoperative bowel obstruction, infertility, and chronic pelvic pain.1–7 Therefore, a method by which postsurgical adhesion formation could be reduced or prevented would be of great benefit in reducing postoperative morbidity and failed surgical therapy. Studies have indicated that placement of an absorbable barrier of oxidized regenerated cellulose (Interceed® [TC7] Absorbable Adhesion Barrier; Ethicon), expanded poly-tetrafluoroethylene (Preclude® Surgical Membrane; W.L. Gore), or hyaluronic acid/carboxymethylcellulose (Seprafilm® Surgical Membrane; Genzyme) between injury sites or addition of a viscous solution (dextran, Hyskon® Solution, Pharmacia; hyaluronic acid, Sepra-coat®, Genzyme) into the peritoneal cavity during or after surgery can reduce postoperative adhesion formation. 8–20 in the case of Interceed barrier, Preclude membrane, or Seprafilm membrane, the surgeon must predict potential sites of adhesion formation to determine placement and optimize barrier benefit. Sepra-coat, a dilute solution of hyaluronic acid (HA), has only been shown to be effective at reducing the number of de novo adhesions at sites remote from the surgical trauma, while the use of Hyskon in clinical practice has shown some undesirable side effects resulting from the accumulation of intraperitoneal ascites from oncotic properties.21 In addition, several reports indicate that Hyskon is ineffective in pelvic surgery because of gravitational pooling in the cul-de-sac.22–26

Keywords

Hyaluronic Acid Adhesion Formation Uterine Horn Surgical Control Adhesion Prevention 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Douglas B. Johns
  • Gere S. DiZerega

There are no affiliations available

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