We analyzed 18 published articles to critically look at the effectiveness of adhesive barriers in operative gynecology. A literature research was performed using internet.

Oxidized regenerated cellulose (Interceed) was found to be an effective adhesion barrier with treated sidewalls showing significantly less area involved with adhesions (p < 0.05). With 4% icodextrin solution (Adept), no significant reduction of de novo adhesions was found in patients undergoing laparoscopic surgery for removal of myomas or endometriotic cysts (p = 0.909). With use of hyaluronic acid (Intergel), a significant difference was found in the mean adhesion severity scores (p < 0.05). The Sepracoat group had a significantly lower incidence of de novo adhesions in terms of proportion of sites involved, percentage of adhesion free patients as well as adhesion extent and severity. Oxiplex was found to prevent an increase in adhesion score when compared to placebo.

The decision whether to use an adhesion barrier or not, need to be a well thought out one after weighing the balance between the efficacy of the material against the cost implications involved. The quest for the best of the adhesive barriers still continues.

Puliyathinkal S, Vahab KPA, Umadevi N, Geetha KC, Mumtaz P, Govind A, Mahesh P, Hashim A. Adhesion Prevention in Operative Gynecology: How Realistic are our Expectations? World J Lap Surg 2014;7(2):88-91.