Adhesion Barrier Helps After Endometriosis Surgery

The use of adhesion barrier does not only reduce the formation of adhesions but also their extent and severity following endometriosis surgery.

Key Points

Highlights: 

• The adhesions barrier "4DryField® PH" could significantly reduce the occurrence, extent, and severity of adhesions following endometriosis surgery.

Importance:

• This finding provides practical benefits for women undergoing surgery to treat their endometriosis.

What's done here:

• Researchers conducted a prospective, randomized, controlled clinical trial to assess the effectiveness of this adhesion barrier.
• Results of 50 patients undergoing surgery to treat extensive and deep infiltrating endometriosis are evaluated.

Key results:

• The use of "4DryField® PH" reduced the formation of adhesions by 53%.
• It also reduced the extent and severity of adhesions by 85%.

Limitations:

• The trial was not double-blind because the operating surgeon knew which group of patients they were treating with 4DryField® PH since no placebo exists for the barrier.
• Surgeons could be getting better at applying the barrier as they perform more surgeries, which could have an effect on the results.
• There may be variation between patients in terms of the amount of powder applied, powder distribution, and volume of saline solution applied to turn the powder into a gel.

Lay Summary

An adhesion barrier, named "4DryField® PH" significantly reduced the formation of adhesions following endometriosis surgery, according to a new study by German scientists. 

The formation of adhesions following endometriosis surgery is a severe problem that affects 90% of patients. The findings of this study, therefore, provide practical benefits for endometriosis patients undergoing surgery. 

In order to evaluate the effectiveness of this particular adhesion barrier in preventing the formation of adhesions following endometriosis surgery, a team of researchers led by Dr. Alice Höller of the Department for Women's Health at University Hospital Tübingen in Germany conducted a prospective, randomized, controlled clinical trial.  A total of 50 patients with extensive and deep infiltrating endometriosis were included in the study. Half of the patients received this particular adhesion barrier, while the other half received saline solution only as of the control group, to compare the formation of adhesion following surgery.

All patients then underwent a second laparoscopic surgery to assess whether they had any adhesions and the extent and severity of the adhesions. The results showed that the severity and extent of adhesions were reduced by 85% in patients who received 4DryField® PH compared to those who only received saline solution. The formation of adhesions was also 53% lower when researchers used 4DryField® PH. 

“Adhesion formation could be reduced significantly by 85% by application of the adhesion barrier 4DryField® PH,” the researchers wrote. 

Adhesions are “sticky” areas of tissues that can join organs together and can lead to chronic pain, ileus or the lack of movement in the intestines, and infertility. 4DryField® PH is a starch-based powder that forms a gel when it comes in contact with saline solution thereby separating surgical sites and preventing the formation of adhesions.

Future studies should investigate the optimum dose, best application mode, and specific molecular impact of this barrier.

Research Source: https://pubmed.ncbi.nlm.nih.gov/34036409/