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      Seprafilm may ease colostomy reversal.

      Archives of surgery (Chicago, Ill. : 1960)

      Animals, Biocompatible Materials, Carboxymethylcellulose Sodium, Colostomy, instrumentation, methods, Female, Hyaluronic Acid, Membranes, Artificial, Pelvis, Postoperative Complications, Rats, Rats, Wistar, Reoperation, Tissue Adhesions, prevention & control

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          In this study, we aimed to investigate whether the use of a sodium hyaluronate and carboxy-methylcellulose-based antiadhesive membrane (Seprafilm, Adhesion Barrier; Genzyme Corp, Cambridge, Mass) is associated with fewer adhesions around the pelvis and rectal pouch. Forty Wistar albino female rats were divided into 4 equal groups. Each rat underwent segmental left-sided colonic resection and end colostomy. The groups were as follows: group 1, colostomy alone (control group); group 2, colostomy and Seprafilm application around distal rectal pouch; group 3, colostomy and Seprafilm application beneath laparotomy incision; and group 4, colostomy and application of Seprafilm on both rectal pouch and laparotomy incision. All animals were operated on the 21st day and intra-abdominal adhesions were evaluated. The results were assessed by analysis of variance and Tukey multiple comparison tests. Intra-abdominal adhesions were significantly (P<.05) reduced in groups 2 through 4 compared with the control group, whereas no statistically significant difference was observed between these 3 groups. The use of Seprafilm during the initial step of the Hartmann colostomy reduced intra-abdominal adhesions on the reversal. This result might be beneficial in the prevention of adhesion-related difficulties during second operation and its application beneath laparotomy incision seems to be sufficient to ensure this effect.

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