C sections and Adhesions

From: Dr. David Wiseman (david.wiseman@adhesions.org)
Tue May 29 08:31:26 2012

Adhesions and C Section - if you've had multiple C sections then you're at much greater risk of adhesions and related complications. If you're thinking about a C section - ask your doctor about adhesion barriers. If you know someone who is having a baby - tell them.

Finally someone is talking about this. I remember trying to get this topic on the agenda in the early 1990s and no-one doctors, companies, wanted to talk about it.

The paper below says that Interceed's use is limited (true) because it needs complete hemostasis (stopping bleeding) and that cannot always be done in C section. Big shame. J&J could make a version that does'nt have this problem. How do I know? I was one of the inventors !!!! The patent I think has expired - anyone want to make this with me??

http://www.google.com/patents/US5134229 Patent US5134229 - Process for preparing a neutralized oxidized cellulose product.....

__________________ Adhesion prevention in patients with multiple cesarean deliveries.

Bates GW Jr, Shomento S.

Department of Obstetrics and Gynecology, University of Alabama-Birmingham, Birmingham, AL 35233, USA. wbates@uab.edu Abstract

Adhesion formation is a well-known complication of abdominal surgery. Although one third of all deliveries in the United States are by cesarean delivery (CD), little is known about adhesions in the obstetric setting. Various surgical techniques for reducing adhesion formation following CD have been investigated. The relative benefits of peritoneal closure and single-layer uterine closure are areas of continued research and debate. Adhesion prevention products are also becoming more commonplace in gynecologic surgery. Two membrane/adhesion barriers have been approved in the United States. A barrier consisting of oxidized regenerated cellulose (Interceed absorbable adhesion barrier) has been shown to reduce adhesions during microsurgery. Its use may be limited following CD because complete hemostasis is crucial to its efficacy. Seprafilm adhesion barrier, composed of hyaluronic acid and carboxymethylcellulose, is approved for use in abdominal or pelvic laparotomy. Preliminary data suggest that it may be effective for reducing adhesions following CD. This article discusses what is currently known about adhesion prevention in the obstetric population and highlights the paucity of level I evidence available to clinicians in this setting.

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