Surgeons have a number of products at their disposal for reducing the risk of adhesions, including synthetic bradley witham barrier agents. It is their responsibility to make patients aware of the potential benefits and risks of using these products before a procedure takes place.
Synthetic barrier products may reduce adhesion risk by replicating the naturally occurring membranes that cover your vital organs. When the delicate surfaces of your organs make contact with each other during surgery – especially abdominal and pelvic surgeries — the tissues may adhere to each other.
Surgical bradley witham trauma often leads to the formation of scar tissue, which can eventually cause the intestines to twist, pull, kink or become blocked. A partial intestinal blockage may be resolved under close medical supervision. A complete blockage is a medical emergency, often requiring immediate surgery. Adhesions after abdominal or pelvic surgery may also cause infertility in women. Severe abdominal pain, nausea, loud bowel sounds and bloating are common symptoms of adhesions.
- How Surgical Barriers Work
In combination with safe operative technique, surgical barriers may reduce the risk of scar formation and adhesion pain. During abdominal or pelvic surgery, synthetic barrier sheets made of regenerated cellulose, polytetrafluoroethylene or Fibrin may be applied to abdominal or pelvic tissues to keep organ surfaces separate. While some commonly used products, such as Gore-Tex, must be sutured into place and removed during a separate procedure, Interceed and Seprafilm, both Johnson & Johnson products, are absorbed into the body after surgery. Note* Insurance companies often do not compensate for the use of barrier products, transferring the financial responsibility onto the patient.
A 2008 review published in the Cochrane Database of Systematic Reviews compared the results of 16 clinical trials to evaluate the effectiveness of four barrier products at preventing adhesions in women undergoing pelvic surgery. The reviewers evaluated the results of using Gore-Tex, Interceed, Seprafilm and Fibrin. In the majority of the trials, Gore-Tex was more effective than Interceed or no barrier at preventing adhesions after surgery. Further clinical studies have shown that Interceed and Seprafilm may reduce the risk of pelvic and abdominal adhesions if they are used correctly.
The SprayShield Adhesion Barrier System, currently available only in Europe, protects internal tissues through the application of a hydrogel spray. The hydrogel barrier, which turns blue upon application so that surgeons can visualize the covered areas, keeps organ surfaces separate both during and after surgery, while the tissues heal. After the necessary healing time, the material is absorbed by the body and excreted by the kidneys in the urine. Although the SprayShield barrier system has performed well in pre-clinical studies in the United States and has been available to patients in Europe since 2008, the product has not yet been approved by the Food and Drug Administration for use in the U.S.