Original CommunicationsSeprafilm reduces adhesions to polypropylene mesh*,**
Section snippets
Animals
Female Sprague-Dawley rats (Sasco, Inc, Madison, Wis) weighing 275 to 325 g, approximately 10 to 12 months of age were used. All rats were acclimated at least one week before the operation to adjust to the laboratory environment, during which time they received standard rat/mouse chow (Harlan, Inc, Madison, Wis) and water ad libitum. They were housed singly in polycarbonate microisolator cages in a controlled environment with a 68° to 78°F temperature and 50% to 70% relative humidity with a
Results
Two animals died of complications from the anesthetic and were replaced. Subcutaneous seromas of varying sizes occurred in most rats. Aspiration of the seroma was done to prevent threatened skin dehiscence in 9 of 39 animals: 3 in the control group, 4 in the visceral Seprafilm membrane group, and 2 in the group with the Seprafilm membrane over the viscera and in the subcutaneous space. The incision opened spontaneously in a single animal from Group 1, and it was eliminated from analysis because
Discussion
These results are in agreement with a similar study by Alponat et al11 who reported fewer adhesions and no adverse effect on healing at the prosthetic mesh abdominal wall interface in rats treated with the Seprafilm membrane placed on the viscera.
In pilot experiments, we observed that intraabdominal adhesions to polypropylene mesh developed within 24 hours after the operation. The total area involved at day 1 varied, but averaged around 60%. Between days 1 and 7, additional adhesions formed
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Cited by (76)
Anti-adhesive bioresorbable elastomer-coated composite hernia mesh that reduce intraperitoneal adhesions
2023, BiomaterialsCitation Excerpt :The smooth degradable film acts a peritoneal interface to prevent adhesions while the prosthetic mesh promotes tissue bio-incorporation. However, these coatings are only minimally effective because they have insufficient properties to resist micro-fractures and delamination, and rapidly degrade (e.g. Proceed®, Sepramesh®, and Parietex® are completely absorbed in 4 weeks) exposing prosthetic mesh prior to neo-peritoneal formation [12–14]. Ideally, an anti-adhesive mesh barrier should be biocompatible, possess adequate mechanical properties and have sufficiently long degradation allowing native peritoneum to reform and remodel on the intraperitoneal surface of the mesh [10,15–24].
Zwitterionic amino acid-based Poly(ester urea)s suppress adhesion formation in a rat intra-abdominal cecal abrasion model
2019, BiomaterialsCitation Excerpt :Unfortunately, there is a chance that the mesh can become adhered to other layers inside the peritoneum space [7–9]. Depending on the mesh selected, the outcomes and chance of problematic adhesion can vary [10–13]. The severity of adhesions can manifest in symptoms ranging from patient discomfort to emergency surgery for complex cases [9,11,14].
Abdominal adhesions: Current and novel therapies
2011, Journal of Surgical ResearchCitation Excerpt :While Seprafilm is one of the most studied and used adhesion prevention therapies, surgeons still argue about the efficacy of the product. The product has shown some efficacy in adhesion prevention in mouse, rat, rabbit, and dog models [43–59]. In addition, randomized, controlled, human trials comprising greater than 5,000 total patients show that Seprafilm has some efficacy in reducing the incidence, severity, extent, and/or area of abdominal adhesions (not all citations evaluate incidence, severity, extent, and area) [32, 40, 60–66].
Laparoscopic Ventral Hernia Repair: Mesh Options and Outcomes
2009, Seminars in Colon and Rectal SurgeryCitation Excerpt :The effectiveness of these meshes at preventing adhesion formation remains unclear. While studies examining adhesion formation in animals have shown a reduction in adhesions following composite mesh implantation secondary to peritonealization of the mesh, other reports have demonstrated fewer adhesions with uncoated ePTFE mesh.29,30 Because of the 2-sided nature of composite meshes, due diligence is required in the operating room to insure proper orientation and avoid placement of PP or PE against the intestinal surfaces.
Injectable Double Crosslinked Hydrogel-Polypropylene Composite Mesh for Repairing Full-Thickness Abdominal Wall Defects
2024, Advanced Healthcare Materials
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Supported by grants from the Genzyme Corporation.
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Reprint requests: John P. Delaney, MD, PhD, University of Minnesota, Health Sciences Center, Box 89, 420 Delaware St, SE, Minneapolis, MN 55455.