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Table 4 Overview of most common applied adhesion barriers and their impact on adhesion formation and incidence of ASBO

From: Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Barrier Marketed as Comments
Hyaluronate carboxymethylcellulose Seprafilm® Solid barrier most suitable for open surgery although laparoscopic placement has been described
Studies in both general surgery and gynecological procedures
Reduces adhesion formation, as well as the risk for reoperations for adhesive small bowel obstruction (relative risk 0.49, 95% CI 0.28–0.88)
Oxidized regenerated cellulose Interceed® Solid barrier most suitable for open surgery
Only studied in gynecological procedures
Reduces incidence of adhesion formation relative risk 0.51, 95% CI 0.31–0.86
No studies available on subsequent risk of ASBO
This workgroup does not recommend the use of this barrier to prevent ASBO in general surgery
Icodextrin Adept® Liquid barrier, easy to apply in both open and laparoscopic surgery
Good safety record in both general surgery and gynecological surgery
Reduces recurrence of ASBO following surgery for ASBO in one trial (relative risk 0.20, 95% CI 0.04–0.88)
Polyethylene glycol Sprayshield®/Spraygel® Gel barrier, easy to apply in both open and laparoscopic surgery
Reduces adhesion score in both general surgery and gynecological trials
Relative few and small studies, impact on long-term adhesion-related complications not described
  1. Adapted from [52]