Murine peritoneal injury and de novo adhesion formation caused by oxidized-regenerated cellulose (Interceed [TC7]) but not expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane)
Haney AF,Doty E
Published January 1992Fertility and Sterility, 57(1), 202-208
Haney, A. F., & Doty, E. (1992). Murine peritoneal injury and de novo adhesion formation caused by oxidized-regenerated cellulose (Interceed [TC7]) but not expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane). Fertility and Sterility, 57(1), 202-208. https://doi.org/10.1016/s0015-0282(16)54802-x
Haney AF, Doty E. Murine peritoneal injury and de novo adhesion formation caused by oxidized-regenerated cellulose (Interceed [TC7]) but not expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane). Fertil Steril. 1992;57(1):202-208. doi:10.1016/s0015-0282(16)54802-x
Haney, A. F., and Elissa Doty. "Murine peritoneal injury and de novo adhesion formation caused by oxidized-regenerated cellulose (Interceed [TC7]) but not expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane)." Fertility and Sterility, vol. 57, no. 1, 1992, pp. 202-208.
For EndNote, Zotero or Mendeley:
Open access
Free to read
No reuse license
Free to read at the publisher (reported by Unpaywall and OpenAlex, not verified by RRM Academy)
Author affiliations
2 institutions
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.
Interceed adhesion barrier caused new adhesions in mice
A 1992 Duke laboratory study in female mice found that the Interceed barrier injured the lining of the abdomen and caused new adhesions in 58% of animals. The Gore-Tex Surgical Membrane caused none in 39 animals. Researchers examined the tissue with electron microscopy for up to 14 days.
Key Findings
Of 43 mice with oxidized-regenerated cellulose inserted, 37 adhesions formed in 25 animals (58%). No adhesions appeared in 29 sham-operated mice or in 39 mice with PTFE.
Adhesions with oxidized-regenerated cellulose involved the liver in 25 of 37 (67%), the bowel in 8 of 37 (22%), and other structures in 4 of 37 (11%).
In mice with nonsutured barriers, electron microscopy showed the surface mesothelial cells completely sloughed by 6 hours with oxidized-regenerated cellulose. The surface healed in 5 to 7 days.
Sutured over a surgical injury in mice, oxidized-regenerated cellulose was followed by adhesions in 9 of 12 animals (75%). With PTFE and hidden knots, none of 11 had adhesions.
Interpretation
This is a controlled animal experiment in 6-week-old female mice. The authors state that their data do not address re-adhesion in tissue that is already scarred. The study was supported in part by both barrier manufacturers. The authors advise caution about general use of oxidized-regenerated cellulose until its effect on human peritoneum is better understood.
RRM Context
Adhesion prevention matters in restorative reproductive medicine, where surgeons work to protect the tissue they repair. In mice, the barrier material itself injured the peritoneum. The choice of adjunct deserves the same scrutiny as the operation. PTFE left the underlying peritoneum largely unchanged.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To evaluate the impact of the materials contained in the available adhesion prevention barriers on the peritoneum.
Design, Setting, and Patients
A murine paradigm was used, placing oxidized-regenerated cellulose (Interceed [TC7]) and expanded polytetrafluoroethylene (PTFE; Gore-Tex Surgical Membrane) in the peritoneal cavity for intervals up to 14 days.
Interventions and Main Outcome Measures
The appearance of the peritoneum on scanning and transmission electron microscopy and the presence of de novo adhesions were the end-points used.
Results
Oxidized-regenerated cellulose caused localized sloughing of the mesothelial cell layer and leukocyte infiltration of the deeper tissue leading to the formation of adhesions to the bowel and liver in 58% of the animals. The surface of the oxidized-regenerated cellulose-injured peritoneum healed in 5 to 7 days. Neither peritoneal injury nor adhesions were noted in sham-operated animals or animals with PTFE.
Conclusions
Oxidized-regenerated cellulose but not PTFE has a localized injurious effect on the peritoneum of the mouse, resulting in de novo adhesions. The impact of the barrier material itself on normal peritoneum may be an important consideration in designing surgical barriers for the prevention of postoperative adhesions.
How fertility-preserving surgery differs by approach: restorative (RRM), specialist, and conventional, across endometriosis, ovarian cysts, PMOS / PCOS, fibroids, tubal disease, Asherman's syndrome, adenomyosis, cesarean scar, pelvic adhesions, and male-factor causes including varicocele and obstruction.
03fm7wh60 