International Journal of Medical Sciences

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17 December 2018

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Int J Med Sci 2016; 13(7):524-532. doi:10.7150/ijms.15167

Research Paper

Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model

D Poehnert1, L Grethe1, L Maegel2, D Jonigk2, T Lippmann2, A Kaltenborn3,4, H Schrem1,3, J Klempnauer1, M Winny1✉

1. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Germany;
2. Institute of Pathology, Hannover Medical School, Germany;
3. Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center-Transplantation (IFB-Tx), Hannover Medical School, Germany;
4. Department of Trauma and Orthopaedic Surgery, Federal Armed Forces Hospital Westerstede, Westerstede, Germany.


Background: Abdominal operations are followed by adhesions, a prevalent cause of abdominal pain, and the most frequent cause for bowel obstruction and secondary female infertility. This rat study addresses adhesion prevention capability of Adept®, Interceed®, Seprafilm®, and a novel device, 4DryField® PH which is provided as powder and generates its effect as gel.

Methods: Sixty-eight male Lewis rats had cecal abrasion and creation of an equally sized abdominal wall defect, and were grouped randomly: A control group without treatment (n=10); two groups treated with 4DryField® PH using premixed gel (n=15) or in-situ gel technique (n=16); one group each was treated with Seprafilm® (n=8), Interceed® (n=9), or Adept® (n=10). Sacrifice was on day 7 to evaluate incidence, quality, and quantity of adhesions, as expressed via adhesion reduction rate (AR). Histologic specimens were evaluated. Statistical analyses used ANOVA and unpaired t-tests.

Results: 4DryField® PH significantly reduced incidence and severity of adhesions both as premixed gel (AR: 85.2%) and as in-situ made gel (AR: 100%), a comparison between these two application techniques showed no differences in efficacy. Seprafilm® did not reduce incidence but severity of adhesions significantly (AR: 53.5%). With Interceed® (AR: 3.7%) and Adept® (AR: 16.1%) no significant adhesion-reduction was achieved. Except for inflammatory response with Interceed®, histopathology showed good tissue compatibility of all other devices.

Conclusion: 4DryField® PH and Seprafilm® showed significant adhesion prevention capabilities. 4DryField® PH achieved the highest adhesion prevention effectiveness without restrictions concerning mode of application and compatibility and, thus, is a promising strategy to prevent abdominal adhesions.

Keywords: Adhesion prevention, abdominal surgery, rat model OPAM, 4DryField® PH, Adept®, Interceed®, Seprafilm®

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Poehnert D, Grethe L, Maegel L, Jonigk D, Lippmann T, Kaltenborn A, Schrem H, Klempnauer J, Winny M. Evaluation of the Effectiveness of Peritoneal Adhesion Prevention Devices in a Rat Model. Int J Med Sci 2016; 13(7):524-532. doi:10.7150/ijms.15167. Available from