Abstract | INTRODUCTION:
Seprafilm adhesion barrier ( Seprafilm) has been proven to prevent adhesion formation after abdominal and pelvic surgery. This article reports safety results, including the postoperative incidence of abdominal and pelvic abscess and pulmonary embolism, from a large, multicenter trial designed to evaluate the safety and effectiveness of Seprafilm for reduction of adhesion-related postoperative bowel obstruction after abdominopelvic surgery. METHODS: A total of 1791 patients participated in this prospective, randomized, multicenter, multinational, single-blind, controlled study in patients undergoing abdominopelvic surgery, the majority of whom had inflammatory bowel disease. Just before closure of the abdomen, patients were randomized to a Seprafilm or no-treatment control group. Patients received an average of 4.4 and as many as 10 Seprafilm adhesion barriers applied to organs and tissue surfaces that sustained direct surgical trauma and to suspected adhesiogenic surfaces. Complications that occurred within the first month after surgery were evaluated. RESULTS: During the safety evaluation period, the difference between the Seprafilm and control groups for the incidence of abscess (4 vs. 3 percent, respectively) or pulmonary embolism (<1 percent in both groups) was not statistically significant (P > 0.05). Foreign body reaction was not reported in either group. Fistula (2 vs. <1 percent) and peritonitis (2 vs. <1 percent) occurred more frequently (P <or= 0.05) in the Seprafilm group. In a subpopulation of patients in whom Seprafilm was wrapped around a fresh bowel anastomosis, leak-related events, which included anastomotic leak, fistula, peritonitis, abscess, and sepsis, occurred more frequently (P <or= 0.05). There were no other differences in the incidence, severity, or causative relationship of complications between study groups. CONCLUSIONS:
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Authors | David E Beck, Zane Cohen, James W Fleshman, Howard S Kaufman, Harry van Goor, Bruce G Wolff, Adhesion Study Group Steering Committee |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 46
Issue 10
Pg. 1310-9
(Oct 2003)
ISSN: 0012-3706 [Print] United States |
PMID | 14530667
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biocompatible Materials
- Membranes, Artificial
- Seprafilm
- Hyaluronic Acid
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Topics |
- Abdomen
(surgery)
- Abdominal Abscess
(etiology)
- Adult
- Biocompatible Materials
(adverse effects)
- Female
- Foreign-Body Reaction
(etiology)
- Humans
- Hyaluronic Acid
- Male
- Membranes, Artificial
- Middle Aged
- Pelvis
(surgery)
- Postoperative Complications
(prevention & control)
- Prospective Studies
- Pulmonary Embolism
(etiology)
- Single-Blind Method
- Tissue Adhesions
(prevention & control)
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