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Title: A sprayable hydrogel adhesion barrier facilitates closure of defunctioning loop ileostomy: a randomized trial.
Epworth Authors: Tjandra, Joe
Chan, Miranda
Keywords: Defunctioning Loop Ileostomy
Complex Peristomal Adhesions
Sprayable Hydrogel Adhesion Barrier
Closure Of Ileostomy
Both Limbs Ileostomy
Blinded Manner
Parastomal Incision
Postoperative Complications
​General Surgery & Gastroenterology Clinical Institute, Epworth Healthcare, Victoria
Issue Date: Jun-2008
Publisher: Wolters Kluwer Health
Citation: 2008 Jun;51(6):956-60
Abstract: PURPOSE: Closure of defunctioning loop ileostomy often is associated with division of complex peristomal adhesions through a parastomal incision with limited exposure. The goal was to determine whether sprayable hydrogel adhesion barrier (SprayGel) will reduce peristomal adhesions and facilitate closure of ileostomy. METHODS: Patients undergoing closure of loop ileostomy were randomized to have hydrogel adhesion barrier sprayed around both limbs of ileostomy for 20 cm (SprayGel group, n = 19), or to control without adhesion barrier (control group, n = 21). Ileostomy was reversed at ten weeks after construction. Extent of peristomal adhesions was scored in blinded manner (each quadrant, range, 1-3: 3 = most severe; total, range, 4-12: 12 = most severe). RESULTS: Use of adhesion barrier was associated with significant reduction in overall adhesion scores (mean, 6.11 vs. 9.67; P < 0.0005), four-quadrant adhesion scores (Quadrant A: 1.68 vs. 2.52, P = 0.002; Quadrant B: 1.42 vs. 2.33, P < 0.0005; Quadrant C: 1.42 vs. 2.24, P < 0.0005; Quadrant D: 1.58 vs. 2.48, P = 0.002), and proportion of patients with dense (scores > or = 8) adhesions (0.11 vs. 0.71; P < 0.0005). Time taken to mobilize (16.53 vs. 21.67 minutes; P = 0.008) and close ileostomy (35.37 vs. 41.90 minutes; P = 0.008) was significantly reduced. Postoperative complications were comparable. CONCLUSIONS: A sprayable hydrogel adhesion barrier placed around the limbs of a defunctioning loop ileostomy reduced peristomal adhesions and might facilitate closure of ileostomy.
DOI: 10.1007/s10350-007-9181-4
PubMed URL:
ISSN: 0012-3706
1530-0358 (Online)
Journal Title: Diseases of the Colon & Rectum
Type: Journal Article
Affiliated Organisations: Department of Colorectal Surgery, Royal Melbourne Hospital, Melbourne, Victoria
University of Melbourne, Melbourne, Australia, Victoria
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Cancer Services

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