Page 61 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Postoperative adhesion prevention with a new barrier
Table 3. Experiment 1, dose finding: the mean Zühlke score compared to the control group (Mann-Witney test, Kruskall-Wallis)
Group A-Part
1 1,2 ml
2 0,8 ml
3 0,4 ml
4 Control
Experiment 2:
Dose finding: Zühlke score
Mean Zühlke p-value
0.73 < 0.001
0.93 0.029
0.79 0.001
1.46 - 3
In the PVA/CMC gel group a significant adhesion reduction of 42.5% was found compared to the control group. In contrast, the icodextrin 4% group did not show any significant adhesion reduction. Mean adhesion coverage was in the A-Part group 26.5%, icodextrin 45.6% and the control 45.6% (PVA/CMS vs control p = 0.017, icodextrin vs control p = 0.925, PVA/CMC vs icodextrin p = 0.027). In the icodextrin group 2 out of 20 (10%) defects, in the PVA/CMC group 7 out of 20 (35%) defects and in the control group 0 out of 20 (0%) defects without adhesions were noted (PVA/CMC vs control p = 0.008, PVA/CMC vs icodextrin p = 0.127, icodextrin vs control p= 0.487). Adhesion coverage is shown in figure 2.
Figure 2. Experiment 2, A-Part compared to Adept: percentage of the abdominal wall defect covered with adhesions compared to the control group (one-way ANOVA)
The Zühlke score was significantly reduced in the PVA/CMC gel group (Zühlke 0.65, p = 0,032) compared to the control group (Zühlke 1,05). Increasing of the Zühlke score in the Icodextrin 4% group was without significance (Zühlke 1.3, p = 0.213).
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