The effectiveness of hyaluronan-carboxymethylcellulose membrane in different severity of adhesions observed at the time of relaparotomies: an experimental study on mice.

PURPOSE: This study was designed to evaluate the effect of Seprafilm use in the presence of different severity of adhesions encountered in relaparotomies.
METHODS: A total of 110 male Balb/c mice were randomized into two experiment groups: Sepra and Control. All animals underwent cecal and small-bowel abrasions during the first operation. The severity of adhesions were evaluated as "slight" or"dense" at the time of relaparotomy performed 14days after the initial operation, and Seprafilm was applied to the animals in Group Sepra. Accordingly, the groups were documented as Sepra-slight, Sepra-dense, Control-slight, and Control-dense. All subjects were killed 14days later, the adhesion severity was evaluated with a scale scoring 0 to 5, and the results were compared between the groups.
RESULTS: The death of 21 animals (19.1 percent) before (n = 10) and after (n = 11) the second operation left 22, 24, 26, and 17 animals in groups Sepra-slight, Sepra-dense, Control-slight, and Control-dense, respectively. Seprafilm significantly reduced the adhesion severity score (1.1 +/- 1.1 vs. 2.1 +/- 1.5 in Groups Sepra and Control, respectively; P < 0.05). Seprafilm did not significantly decrease the severity of adhesions in the presence of slight adhesions at the time of relaparotomy (P > 0.05). However, the analysis of groups revealed that Seprafilm was more effective when used during the observation of severe adhesions at the time of relaparotomy (1.7 +/- 1.4 vs. 2.7 +/- 1.5 in Groups Sepra-dense vs. Control-dense, respectively; P < 0.05).
CONCLUSIONS: Seprafilm is effective in preventing adhesions even if it is used at the time of relaparotomy, but the antiadhesive effect of product peaks when it is used during the observation of dense adhesions at the time of relaparotomy.