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IMPORTANT SAFETY INFORMATION

Seprafilm should not be wrapped around an intestinal anastomosis as such usage may result in increased anastomotic leak-related events, such as abscess or peritonitis. The safety and effectiveness of Seprafilm [...]  View Full Important Safety Information

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About Adhesions

UP TO 93% OF PATIENTS DEVELOP ADHESIONS FOLLOWING INITIAL LAPAROTOMY1,2


What are Adhesions?

Adhesions are fibrinous bands of internal scar tissue that can cause internal tissues and organs that are normally separated to stick together.5  They are a common complication in abdominal surgery.3,4 Adhesions are reported to cause:*

  • Short- and long-term patient morbidities, including small bowel obstruction (SBO)3,5
  • Surgical complexity during reoperation3
  • Economic burden for patients, third-party payers, and society as a whole3

*Note: Seprafilm is not indicated for the reduction of adhesion-related complications.

How Adhesions Form

The images herein depict the 7-day post-surgical healing period during which new adhesions can form.

Note: Some cellular-level activity statements contained herein are supported by preclinical animal studies and may not reflect clinical outcomes in humans.

The 7-day Adhesion Formation Period

Potential Causes of Adhesions

Adhesion formation is a complex biological process triggered by an inflammatory response to trauma and a prolonged suppression of fibrinolytic activity following peritoneal injury. Common causes of adhesions include:1,3

  • Tissue manipulation
  • Desiccation
  • Abrasion
  • Heat or electrocautery
  • Foreign particles
  • Suturing
  • Factors causing tissue damage

Because adhesion formation is the body’s natural response to tissue trauma, unfortunately, even meticulous surgical technique alone is not adequate to prevent adhesions.3

Adhesion Treatment and Prevention

Currently there is no treatment for adhesions; some complications from adhesions may require adhesiolysis (the removal of existing adhesions), which may result in additional adhesions. Unfortunately, meticulous surgical technique alone is not enough to prevent adhesions. As such, adhesion barriers may be placed prophylactically during surgery to reduce the incidence and severity of adhesions before they form.3

References

  1. Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996;183(4):297-306.
  2. Menzies D, Ellis H. Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl. 1990;72(1):60-63.
  3. Bruggmann 0, Tchartchian G, Wallwiener M, Munstedt K, Tinneberg HR, Hackethal A. Intra-abdominal adhesions. Dtsch Arztebl Int. 2010;107(44):769-775.
  4. Raftery A. The Biology of Peritoneal Tissue Repair. In: DiZerega G, ed. Peritoneal Surgery. New York, NY: Springer; 2000:65-74.
  5. Ricketts SA, Sibbons PD, Green CJ. Quantitative analysis of the development of experimentally induced post surgical adhesions: a microstereological study. Int J Exp Path. 1999;80:325-334.
  6. Divilio, LT. Surgical Adhesion Development and Prevention. Int. Surg. 2005;90:S6-S9.
  7. diZerega GS, Campeau JD. Peritoneal repair and post-surgical adhesion formation. Hum Reprod Update. 2001;7(6):547-555.