Adhesion formation after bowel surgery is a significant problem. The objective of this study was to evaluate two adhesion barriers composed of oxidized
regenerated cellulose (ORC) in a model of bowel surgery, with and without
bleeding. Ceca of female New Zealand White rabbits were abraded with gauze and a 3 x 5 cm patch of peritoneum and underlying muscle was excised from the right sidewall. Animals were randomized to receive no treatment,
INTERCEED Barrier (Ethicon, Inc.), or neutralized
INTERCEED (nTC7). ORC fabrics were applied to the excision site. Seven days later the percentage of the site and length of cecum with adhesions were estimated. The study was replicated in the presence of blood by nicking small vessels near the site sufficient to saturate the fabrics with blood. With hemostasis, the percentage of the sidewall with adhesions was reduced (p < .01) from 63.2 +/- 14.7% in controls (n = 6) to 4 +/- 2.7% with
INTERCEED Barrier (n = 6) and 3 +/- 1.2% (n = 5) with nTC7. With
bleeding, however, control (n = 5) levels of adhesions (67 +/- 17.5%) were reduced significantly with nTC7 (5.5 +/- 4%, n = 4; p < .01), but not
INTERCEED Barrier (34.2 +/- 18.4%, n = 4). Similar trends were observed when the extent of adherent cecum was examined, since the cecum was the main site of adherence to the sidewall. However in the presence of blood, there was no effect of
INTERCEED Barrier on cecal adhesions. We conclude that with hemostasis, both absorbable fabrics of ORC reduced adhesion formation between the injured cecum and abdominal sidewall. The effectiveness of
INTERCEED Barrier, but not nTC7, was reduced but not eliminated in the presence of
bleeding. This confirms similar observations in models of
gynecologic surgery.