Abstract

Aim: To evaluate the efficacy of bioresorbable Seprafilm membrane in avoiding abdominal adhesions.
 Material and methods: After obtaining approval from the appropriate institutional review board, this research was conducted within the department of General Surgery. Patients who needed a Hartmann procedure for diverticulitis or rectosigmoid blockage were randomly assigned to receive Seprafilm or to act as a control patient.
 Results: This research covered 100 patients in total. 50 patients were randomly assigned to receive Seprafilm while the other 50 served as controls. There were no significant variations in medical history or preoperative physical examination. At the midline incision, five patients got three Seprafilm membranes, 35 patients received two membranes, and ten patients received one membrane. In 40 patients, additional surgical operations were performed during the Hartmann procedure. In the Seprafilm group, 8 patients had appendectomy, 6 had surgical decompression of the small intestine, 3 had his peritoneal dialysis catheter removed, and 3 had ovarian cyst resection and partial small intestinal resection for unintentional bowel perforation. In the control group, 8 patients had further appendectomy, 6 patients had splenectomy, 3 patients had suturing for an iatrogenic bladder damage, and 3 patients had partial small bowel resection for a mesentery abscess. The median blood loss in the Seprafilm group was 352mL and 420mL in the control group. Postoperative wound healing was abnormal in 18 of the Seprafilm patients and 14 of the control patients. The time between the original operation and the follow-up surgery was not statistically different across groups. The median interval in the Seprafilm group was 6 months (range 2-17) and 4 months in the control group (range 1–31).
 Conclusion: we concluded a decrease in the degree of adhesion development following the application of Seprafilm in Hartmann procedure patients compared to controls.

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