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A Sprayable Hyaluronate/Carboxymethylcellulose Adhesion Barrier Exhibits Regional Adhesion Reduction Efficacy and Does Not Impair Intestinal Healing

  • 2011 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

While bioresorbable solid barriers such as Seprafilm® prevent adhesions, their efficacy is limited to sites of application. The aim of this study was to assess the effectiveness of the sprayable adhesion barrier Sepraspray® in preventing adhesions to sites of direct application and to remote sites.

Methods

Intraabdominal adhesions were induced in 30 rats by creating three ischemic buttons on each side of a midline incision. To assess efficacy, Sepraspray (5 mg/button) or Seprafilm (1 cm2/button) was applied over three buttons on one side of the peritoneum. Operated control animals received no treatment. On day 7, adhesions were scored as percent of buttons with adhesions. To assess safety, 81 rats underwent a colonic transection repaired with an end-to-end anastomosis. Both barriers were applied circumferentially to anastomoses. Controls received no product. The integrity of healing anastomosed colonic wounds was assessed by burst pressure and tensile strength at days 3, 5, and 7 postoperatively.

Results

The direct application of both Sepraspray and Seprafilm significantly (p < 0.001) reduced adhesion formation compared to controls. While Seprafilm had no remote effect on adhesion formation, Sepraspray significantly (p < 0.001) reduced adhesion formation to contralateral ischemic buttons. Neither barrier affected anastomotic integrity at any time point.

Conclusions

Sepraspray has widespread efficacy throughout the peritoneum in reducing adhesions without compromising intestinal healing. Furthermore, this sprayable alternative offers the potential for easier intraabdominal application.

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Acknowledgements

The authors wish to thank M. Jude Colt, BA; Rubina L. Corazzini, BS; Olga L. Syrkina, MD; Keith Greenawalt, MS; and Thomas Jozefiak, PhD from the Genzyme Corporation for their advice and technical support regarding the application of the Sepraspray barrier preparations and the measurement of anastomotic tensile strength.

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Authors and Affiliations

  1. Department of Surgery, Boston University Medical Center, 88 East Newton Street, C-500, Boston, MA, 02118, USA

    Holly K. Sheldon, Melanie L. Gainsbury, Michael R. Cassidy, Daniel I. Chu, Arthur F. Stucchi & James M. Becker

Authors
  1. Holly K. Sheldon
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  2. Melanie L. Gainsbury
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  3. Michael R. Cassidy
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  4. Daniel I. Chu
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  5. Arthur F. Stucchi
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  6. James M. Becker
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Corresponding author

Correspondence to James M. Becker.

Additional information

Holly K. Sheldon and Melanie L. Gainsbury contributed equally to this publication as first authors. Arthur F. Stucchi and James M. Becker contributed equally to this publication as senior authors.

Grant Support

This research was supported, in part, by the Tyler and Smithwick Endowment Funds, Department of Surgery, Boston University School of Medicine and by an Educational Surgical Research Fellowship grant from the Genzyme Corporation, Cambridge, MA, USA.

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Sheldon, H.K., Gainsbury, M.L., Cassidy, M.R. et al. A Sprayable Hyaluronate/Carboxymethylcellulose Adhesion Barrier Exhibits Regional Adhesion Reduction Efficacy and Does Not Impair Intestinal Healing. J Gastrointest Surg 16, 325–333 (2012). https://doi.org/10.1007/s11605-011-1709-1

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  • DOI: https://doi.org/10.1007/s11605-011-1709-1

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