Effectiveness of seprafilm as Adhesion Barrier following Abdominopelvic Surgery: An Experimental study

Shyam Sundar, S R (2017) Effectiveness of seprafilm as Adhesion Barrier following Abdominopelvic Surgery: An Experimental study. Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Post operative adhesions form one of the most common complication following abdominopelvic surgeries. the consequence of adhesion leads to lifelong morbidity and form major burden in surgeons operating for the second time. Few complications of adhesions include postoperative adhesive colic, bowel obstruction and female infertility Frequent readmissions leads to mobility of patients. Difficulty in resurgery on opening the abdomen for the second time comprises an important outcome of adhesions.Adhesiolysis stays atemporary mainstay treatment to remove adhesions as they tend to reccur following subsequent surgeries. There is need for thorough understanding of the formation adhesions, which is mainly due to reaction of the peritoneum with the intestinal loops which comes in contact with it, the complication of peritonitis, the pathology of bowel obstruction and the evolution of the adhesion barrier. RESEARCH PROPOSAL: a) AIM AND OBJECTIVES OF THE STUDY: Effectiveness of Seprafilm as adhesion barrier among patients undergoing elective laparotomy. e) METHOD OF COLLECTION OF DATA: a. Patients under the study group will be subjected to placement of seprafilm. b. Contrast Enhanced Computerised Tomogram will be performed for all the patients (both study and control) during 20th post operative day DISCUSSION: Results In our study distribution of age is categorised into age<40,41-50 and 51-60.The Mean age in cases is 46.2 and in control group was 46.36.The p value is 0.963 which is not significant. Thus in our study age does not contribute in formation of adhesions for the placement of Sepra In this study male:female ratio in the study group is 11:19 and in the control group is 12:18.The p value is 0.946 which is not significant. Thus male and female have equal preponderance in formation of postoperative adhesions thus In this study 17 cases in the study group and 15 cases in the control group had previous history of surgery. There is no specific difference in the changes in adhesions in previous history of laparotomy done. favouring application of seprafilm in both sex 3 patients developed postoperative fever which settled before 3rd postoperative day.1 case developed wound infection which was managed conservatively. In the control group 9 cases developed fever which settled within 3rd post operative day.4 patients developed postoperative pain till 7th day which may attribute to formation of adhesions as all developed adhesions in the 20th day CT. CONCLUSION: Out of 30 patients only 4 patients developed mimimal adhesions as compared to 16 patients who developed adhesions in the control group as evident by the 20th 90 day CT. The pvalue 0.037 which is significant thus proving the effectiveness of seprafilm as an adhesion barrier in abdominopelvic surgery.

Item Type: Thesis (Masters)
Uncontrolled Keywords: seprafilm, Adhesion Barrier, Abdominopelvic Surgery, Experimental study.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 18 Mar 2020 01:49
Last Modified: 18 Mar 2020 01:49
URI: http://repository-tnmgrmu.ac.in/id/eprint/12299

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