PURPOSE: Hyaluronate carboxymethylcellulose-based bioresorbable membrane (HC membrane; Seprafilm(®)) is used to prevent postoperative adhesion. We conducted this study to assess the effectiveness of the HC membrane in reducing the severity of adhesions in patients undergoing unplanned re-laparotomy. METHODS: Between February, 2002 and December, 2010, 123 patients underwent abdominal surgery followed by a re-laparotomy in Kumamoto Regional Medical Center. The HC membrane was placed under the first abdominal incision in 60 patients (HC membrane group), whereas it was not used in the other 63 patients (control group). We compared the medical and operative records of these two groups. RESULTS: At the second laparotomy, adhesion under the incision was severe in many of the control group patients, but was significantly reduced in the HC membrane group. Postoperative small-bowel obstruction was significantly less frequent in the HC membrane group. According to univariate analysis of the risk factors for adhesion, prolonged operation time, blood loss, and not using an HC membrane were significantly associated with severe adhesion. Multivariate analysis revealed that only not using the HC membrane was significant. CONCLUSION: The HC membrane effectively reduces the severity of wound adhesion, making unplanned repeated laparotomy safer.
PURPOSE:Hyaluronate carboxymethylcellulose-based bioresorbable membrane (HC membrane; Seprafilm(®)) is used to prevent postoperative adhesion. We conducted this study to assess the effectiveness of the HC membrane in reducing the severity of adhesions in patients undergoing unplanned re-laparotomy. METHODS: Between February, 2002 and December, 2010, 123 patients underwent abdominal surgery followed by a re-laparotomy in Kumamoto Regional Medical Center. The HC membrane was placed under the first abdominal incision in 60 patients (HC membrane group), whereas it was not used in the other 63 patients (control group). We compared the medical and operative records of these two groups. RESULTS: At the second laparotomy, adhesion under the incision was severe in many of the control group patients, but was significantly reduced in the HC membrane group. Postoperative small-bowel obstruction was significantly less frequent in the HC membrane group. According to univariate analysis of the risk factors for adhesion, prolonged operation time, blood loss, and not using an HC membrane were significantly associated with severe adhesion. Multivariate analysis revealed that only not using the HC membrane was significant. CONCLUSION: The HC membrane effectively reduces the severity of wound adhesion, making unplanned repeated laparotomy safer.
Authors: Victor W Fazio; Zane Cohen; James W Fleshman; Harry van Goor; Joel J Bauer; Bruce G Wolff; Marvin Corman; Robert W Beart; Steven D Wexner; James M Becker; John R T Monson; Howard S Kaufman; David E Beck; H Randolph Bailey; Kirk A Ludwig; Michael J Stamos; Ara Darzi; Ronald Bleday; Richard Dorazio; Robert D Madoff; Lee E Smith; Susan Gearhart; Keith Lillemoe; Jonas Göhl Journal: Dis Colon Rectum Date: 2006-01 Impact factor: 4.585
Authors: H Ellis; B J Moran; J N Thompson; M C Parker; M S Wilson; D Menzies; A McGuire; A M Lower; R J Hawthorn; F O'Brien; S Buchan; A M Crowe Journal: Lancet Date: 1999-05-01 Impact factor: 79.321
Authors: Dong Sik Bae; Jung-Woo Woo; Se Hyun Paek; Hyungju Kwon; Young Jun Chai; Su-Jin Kim; June Young Choi; Kyu Eun Lee; Yeo-Kyu Youn Journal: J Korean Surg Soc Date: 2013-10-25
Authors: Erik C Dreaden; Stephen W Morton; Kevin E Shopsowitz; Jae-Hyeok Choi; Zhou J Deng; Nam-Joon Cho; Paula T Hammond Journal: ACS Nano Date: 2014-08-11 Impact factor: 15.881