1. What are adhesions?
Adhesions are internal scars—fibrous connections between tissues and organs—that form in response to tissue injury common during surgery. Adhesions that prevent tissues and organs from moving freely can lead to a number of complications, including small bowel obstruction¹, infertility², and chronic pelvic pain.³

2. What causes adhesions to form?
Adhesions can form as a result of tissue injury during surgery, abdominal and pelvic therapies such as radiation, or other diseases, such as cancer and endometriosis. Because surgery involves the cutting and manipulating of internal tissues, when these tissues and organs heal close together, adhesions may form between them. Learn more about adhesions and why they form.

3. How do adhesions lead to complications?
Adhesions that prevent tissues and organs from moving freely can become a health issue, causing the affected tissues and organs to become twisted or pulled from their normal positions. Following surgery, this internal trauma can cause future complications such as adhesive small bowel obstruction, infertility, and chronic pelvic pain.

4. Are adhesions common following open abdominal and pelvic surgery?
Adhesions are common following open abdominal and pelvic surgery. They have been documented to occur in up to 93% of patients after major abdominal surgery⁴, and up to 95% of patients after major gynecologic surgery.² Learn more about the types of gynecologic surgeries and abdominal surgeries that can lead to adhesions.

5. How is small bowel obstruction related to adhesions?
Small bowel obstruction can be a major complication following both abdominal and pelvic surgery and may require additional surgery. Adhesions can lead to adhesive small bowel obstruction by distorting the normal orientation or free movement of the small bowel, causing ‘kinks’ that obstruct the flow of bowel contents. Adhesions have been reported to account for up to 75% of small bowel obstructions.⁶

6. How is infertility related to adhesions?
Infertility can be a major complication following abdominal and pelvic surgery in women. Adhesions can lead to infertility by altering the normal orientation of the ovaries, fallopian tubes, or uterus. This can block the ovum (egg) from traveling into the uterus, making it impossible to become pregnant.² Adhesions have been reported to account for up to 40% of infertility cases.²

7. How is chronic pelvic pain related to adhesions?
Chronic pelvic pain can be a complication following both abdominal and pelvic surgery. The abnormal orientation of tissues and organs caused by adhesions may lead to discomfort and chronic pain. Adhesions are reported to be associated with nearly 50% of chronic pelvic pain cases.³ Unfortunately, it can be difficult to diagnose adhesions as the cause of chronic pelvic or abdominal pain.

8. How do adhesions from a previous surgery complicate future surgeries or other future treatments?
Adhesions can increase the risk, complexity, and complications during future surgeries by making it difficult for surgeons to identify, reach, and separate tissues. Surgeons must take considerable time and effort to cut tissues joined by adhesions⁷, which can result in further damage to tissue and future medical complications. Learn more about the impact of adhesions on future surgeries. Additionally, some patients with adhesions may not be considered appropriate candidates for some cancer treatment options, including certain types of chemotherapy⁸ and radiation therapy.⁹ Learn more about the impact of adhesions on future treatment options.

9. Can adhesions, once formed, be treated with medication, massage, or other methods?
The only way to remove adhesions is through surgery.

10. Is there a way to reduce adhesions?
Yes. Surgeons have developed techniques to minimize tissue damage during surgery, and can use SEPRAFILM^® Adhesion Barrier to reduce adhesions following open abdominal and pelvic surgery. SEPRAFILM Adhesion Barrier reduces the incidence, extent, and severity of adhesions by separating surfaces while injured tissues in the abdomen and pelvis heal.

11. How does SEPRAFILM work?
SEPRAFILM is a piece of clear, reabsorbable film that is applied during open surgery. It sticks to your internal tissues and separates your organs to help prevent them from attaching to one another as they heal. SEPRAFILM is made up of chemically modified sugars, some of which occur naturally in the human body. Once placed inside the body, SEPRAFILM is reabsorbed within seven days, so it does not remain and does not need to be removed. Learn more about how SEPRAFILM works.

12. Is SEPRAFILM effective?
In clinical trials, SEPRAFILM was shown to reduce the incidence, severity, and extent of adhesions.^5,10 These trials included patients undergoing open abdominal and pelvic surgery.  Read about the studies that have been done on SEPRAFILM.

13. Is SEPRAFILM safe?
Side effects are consistent with those typically seen following surgery when SEPRAFILM is used as directed.¹¹  SEPRAFILM is approved by the U.S. Food and Drug Administration (FDA). Please see the SEPRAFILM package insert for full product information.

Fallopian Tube Either of the pair of tubes that carry the eggs from the ovary to the uterus—also called the uterine tubes Full glossary

Uterus A female reproductive organ for containing and providing nourishment to a fetus during development prior to birth (often referred to as the womb). Full glossary

Ovaries Female reproductive organs that produce eggs and female sex hormones. Full glossary

Ovum A mature egg that is ready for fertilization. Full glossary

Endometriosis The formation or growth of endometrial tissue (tissue in the inner layer of the uterine wall) in places other than the uterus. This tissue frequently forms cysts. Full glossary

Food and Drug Administration The U.S. government agency that regulates food, drugs, and medical devices sold in the United States. Full glossary

Adhesions Internal scars that may form after surgery on or between internal organs and/or body tissue. Adhesions between tissues can twist and pull organs out of their normal places. Full glossary

Infertility The inability to become pregnant. Full glossary

1. Ellis H, Moran B, et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet. 1999;353(9163):1476-1480.

 

10. Diamond MP. Reduction of adhesions after uterine myomectomy by SEPRAFILM membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Fert Steril. 1996;66(6): 904-910.

 

11. SEPRAFILM Prescribing Information. Cambridge, MA: Genzyme Biosurgery; 2007.

 

2. 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.

 

2. 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.

 

2. 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.

 

2. 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.

 

3. Keltz MD, Gera PS, Olive DL.  Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain. JSLS 2006;10(4):443-6.

 

3. Keltz MD, Gera PS, Olive DL.  Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain. JSLS 2006;10(4):443-6.

 

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

 

5. Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996;183:297-306.

 

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

 

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

 

9. Eifel PF.  Radiation therapy. In: Berek JS, Hacker NF, editors. Practical Gynecologic Oncology, 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005: 119-161.