SEPRAFILM® and Trauma Surgery

Adhesions are a common consequence of abdominal surgery, forming in 93% of patients who undergo abdominal laparotomy.¹ Trauma patients may undergo a series of restorative abdominal surgeries, which may be increasingly complicated by the presence of adhesions. In addition, potential for adhesive small bowel obstruction is relatively high due to the extent of tissue manipulation. Moreover, patients who are admitted for violent trauma may be readmitted for future surgery that may be complicated by the presence of adhesions.

"Concrete abdomen" - cohesive adhesions between loops of small bowel

The effects of adhesions on subsequent surgery may include:

• Increased procedure and re-entry time³
• Difficulty differentiating and accessing tissue planes⁴
• Increased risk of inadvertent enterotomy⁵

For patients, the consequences of adhesions can be serious. Adhesions account for up to:

• 75% of small bowel obstructions⁶
• 40% of infertility cases⁷
• 48% of chronic pelvic pain cases⁸

1. Menzies D, Ellis H. Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl. 1990;72:60-63.

 

3. Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, et al.  Adhesion-related hospital readmissions after abdominal and pelvic surgery:  a retrospective cohort study. Lancet1999;353(9163):1476-1480.

 

4. Nichols DH, Clarke-Pearson DL, eds. Gynecologic, Obstetric, and Related Surgery. 2^nd ed. St. Louis, MO: Mosby, Inc; 1993.

 

5. Van der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, Reijnen MMPJ, Schaapveld M, van Goor H.  Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg. 2000;87(4):467-471.

 

6. Scovill WA. Small bowel obstruction. In: Cameron JL, ed. Current Therapy in Surgery. St Louis, MO: Mosby Yearbook Medical Publishers, Inc; 1995:100-104.

 

7. DiZerega GS.  Peritoneal repair and postsurgical adhesion formation. In: Management of Common Problems in Obstetrics & Gynecology. Mishell DR, Goodwin Murphy T, Brenner PF, eds. Malden, MA: Blackwell Publishing; 2002: 267-271.

 

8. Stovall TG, Elder RF, Ling FW. Predictors of pelvic adhesions. J Reprod Med. 1989;34:345-348.