Evaluation of resorbable barriers for preventing surgical adhesions

Objective: To evaluate the ability of collagen film, collagen gel, sodium hyaluronate/carboxymethylcellulose film, and fibrin glue to prevent adhesion formation. Design: Randomized trial using a rat model of a standardized abdominal wound and cecal wound. Setting: University research laboratory. Animal(s): Sprague-Dawley female rats. Intervention(s): Resorbable barriers or no barrier (controls) were placed between an abdominal wall wound (1 cm x 2 cm) and a similarly sized cecal wound. Main Outcome Measure(s): Adhesion formation between wounds was assessed and quantitated 7 days after surgery. Result(s): Without treatment, 34 of 35 untreated rats (97%) developed adhesions. Treatment with collagen gel (3 of 33 rats), collagen film (3 of 10 rats), or sodium hyaluronate/carboxymethylcellulose film (2 of 10 rats) significantly reduced the incidence of adhesion formation. Treatment with fibrin sealant resulted in 9 of 10 animals having adherent wounds 7 days after surgery. Conclusion(s): Resorbable barriers of collagen gel, collagen films and sodium hyaluronate/carboxymethylcellulose film were effective in significantly reducing adhesion formation. Fibrin sealant at 7 days had an incidence of adhesion formation similar to that in untreated control animals. Fertil Steril(R) 2000;73:157-61. (C)1999 by American Society for Reproductive Medicine.