Effectiveness of two barriers at inhibiting post-radical pelvic surgery adhesions.

OBJECTIVE

To compare the abilities of Gore-Tex Surgical Membrane (Gore-SM) and Interceed to inhibit post-radical pelvic surgery adhesion formation in a porcine model of radical hysterectomy, salpingo-oophorectomy, and resection of pelvic peritoneum.

METHODOLOGY

Twenty-seven hogs were evaluated. After completion of the radical resection animals were randomized to no treatment or covering the peritoneal defect with a tailored sheet of Gore-SM or Interceed. The Gore-SM was secured in place using a continuous running 4-O Prolene suture while the Interceed was allowed to adhere without sutured attachment. Four weeks after the initial surgery, the animals were reexplored, adhesions quantified, and note was made of any segments of small bowel that were adherent into the pelvis.

RESULTS

One animal in each of the treatment groups died of respiratory compromise in the postoperational period. Adhesion scores for the Interceed covered pelvis (n = 9; mean = 0.04 +/- 0.04) were significantly less than those treated with Gore-Sm (n = 9, mean = 0.18 +/- 0.15, P = 0.02). Both treated groups had significantly fewer adhesions in the pelvis than did the controls (n = 7, mean 1.33 +/- .51; vs Interceed P = 0.0005, vs Gore SM, P = 0.0007).

CONCLUSIONS

Interceed was a more effective barrier for postoperative adhesion prophylaxis than the Gore-SM. Interceed also offered a technical advantage at time of placement.