Effectiveness of Seprafilm in Reducing Postoperative Adhesions after Abdominopelvic Surgery: A Prospective Interventional Study

Introduction: Postoperative adhesions are indeed a significant concern following abdominopelvic surgeries. These fibrous bands of tissue can form between abdominal or pelvic organs and tissues, leading to various complications. Postoperative Peritoneal Adhesions (PPAs) barriers are safer and better because they lower the risk of illness and the need for repeated interventions. Various agents and techniques have been studied to prevent PPAs, including activating fibrinolysis, interrupting blood coagulation, inhibiting collagen synthesis, reducing cellular inflammatory responses, and creating a physical barrier between the wound and surrounding tissue or organ. Seprafilm acts as a physical barrier on wounded tissue surfaces, minimising tissue adhesions during wound healing. Aim: To compare the outcomes of patients undergoing abdominopelvic surgery with and without Seprafilm application, in terms of adhesion formation and complication rates. Materials and Methods: The present prospective interventional study was conducted at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, from July 2023 to December 2024. In this study, group A, 50 patients underwent surgery with the use of Seprafilm, while group B (50 patients) underwent surgery without the use of Seprafilm. The outcomes measured were: postoperative complications, 20th day adhesions as seen in CT abdomen, postoperative pain, and intraoperative blood loss. Blood loss was estimated using a Gauze Visual Analogue (GVA), and pain was estimated using a visual pain analogue. Results: Among the 100 patients, the mean age was 44 years in group A and 45 years in group B, and among the gender distribution, group A had 21 males and 29 female patients, group B had 23 males and 27 female patients. A total of 42 patients (42%) belonged to the age group of <40 years, of which 22 patients (44%) belonged to group A and 20 patients (40%) belonged to group B. In the present study, 10 patients developed postoperative complications in group A and 22 patients developed postoperative complications in group B (p-value=0.010). A total of 34 patients had developed adhesions, among which 8 (23.5%) patients belonged to group A and 26 (76.5%) belonged to group B (p-value=0.001). Conclusion: In this study, the group that used seprafilm as an adhesion barrier following abdominopelvic surgeries had a significant reduction in the incidence of postoperative adhesions compared to the group in which an adhesion barrier was not used.