The Value of Seprafilm Adhesion Barrier

This article aims to shed light on the value Seprafilm Adhesion Barrier brings to both patients and healthcare providers by evaluating cost of adhesion-related healthcare burdens. Join us in exploring the intricate balance between cost, care and clinical outcomes in the context of abdominopelvic surgeries. Timothy Rafferty, Associate Director of Marketing, Baxter's Advanced Surgery, will provide an overview of the economic burden of adhesions and the potential cost savings as a result of the utilization of adhesion prevention agents such as Seprafilm Adhesion Barrier.

Introduction

Post-surgical adhesions are one of the most common causes of complications after abdominopelvic surgery potentially leading to female infertility, chronic pelvic pain and small bowel obstruction.^2,5 Following abdominopelvic surgery, patients have a lifelong risk for developing adhesions.⁵ Surgical techniques to avoid adhesion formation have not proven to be sufficient and pharmaceutical approaches for their prevention are even less effective, which means the use of adhesion prevention devices is essential to help mitigate the risk adhesions pose.³ While the possible medical impact of adhesions is well known among surgeons, the extent of the economic ramifications of adhesions is often neglected.³

What are Abdominopelvic Adhesions?

During abdominopelvic surgeries, intentional or accidental trauma to the serosal surfaces prompts the body's healing process, which can inadvertently lead to the formation of adhesions.⁸ These fibrous bands of scar tissue develop as part of the inflammatory response, aiming to repair the damaged tissue.⁸ However, a fibrinous mass that persists beyond the 3 to 5 days required for remesotheliazation can abnormally bind organs and tissues together, causing a range of complications.^2,8 Thus, the critical time to prevent or diminish adhesion development is in the initial 3 to 5 days after the surgical procedure.⁸

Why Is It Important to Help Prevent Abdominopelvic Adhesions?

The prevention of abdominopelvic adhesions is crucial due to their potential to cause pain, bowel obstructions, infertility and complications in subsequent surgeries.² These issues not only affect the patient's quality of life but also lead to increased healthcare costs due to additional treatments, longer hospital stays and the need for further surgical interventions.^2,6 Adhesions remain an important surgical problem, and hospitalization for adhesiolysis leads to a high direct cost burden.⁶

What Can Surgeons Do to Prevent Post-Surgical Abdominopelvic Adhesions?

While meticulous surgical techniques can minimize tissue damage and reduce the risk of adhesion formation, they cannot eliminate the risk entirely.^3,8 The inherent nature of surgical interventions, involving tissue hypoxia/ischemia and dessication, and exposure to foreign materials, predisposes patients to adhesion development.⁹ Thus, additional preventive measures are essential.³

What Are Adhesion Barriers?

Adhesion barriers represent a pivotal advancement in surgical practice. These are biomaterials designed to be placed between tissues during surgery to prevent the formation of adhesions.^8,10

Seprafilm Adhesion Barrier was approved in the United States (US) in 1996 and is available in North America and worldwide.^8,10,11 Seprafilm Adhesion Barrier is indicated for use in patients undergoing abdominal or pelvic laparotomy as an adjunct intended to reduce the incidence, extent and severity of postoperative adhesions between the abdominal wall and the underlying viscera such as omentum, small bowel, bladder and stomach, and between the uterus and surrounding structures such as tubes and ovaries, large bowel and bladder.¹⁰

Seprafilm Adhesion Barrier is applied to the surface of injured tissue and forms a gel coating within 24 to 48 hours of placement.¹⁰ The gel acts as physical barrier to separate adjacent serosal tissues during the critical stages of wound repair.⁸ During the transition from a solid to gel, the volume of the barrier increases, but the swelling does not affect peritoneal tissue or organ function.⁸ The barrier is resorbed from the site of application within 7 days and does not require removal.⁸ Radiolabeled studies showed that Seprafilm Adhesion Barrier is totally cleared from the body within 28 days following implantation, and the rapid degradation reduces the risk of a foreign body tissue response.⁸

Seprafilm Adhesion Barrier can be cut and tailored to fit the size and shape of the surgical area.¹⁰ Once in place, it adheres to the tissue and forms a barrier.¹⁰ The application process is straightforward and the product is ready to use directly from the packaging.¹⁰ In addition, new application methods in hybrid robotic and laparoscopic procedures have further enhanced its utility in facilitating tissue separation and reducing adhesions in a wide variety of surgical scenarios.¹⁰

For over 25 years, Seprafilm Adhesion Barrier has been used for adhesion prevention in abdominal and pelvic surgery and has been extensively evaluated in clinical trials.^10,11-13 The safety and efficacy of Seprafilm Adhesion Barrier have been evaluated in two (2) randomized, controlled, multicenter trials in abdominal and pelvic surgery.^10,12,13 Both studies demonstrated that Seprafilm Adhesion Barrier reduces the incidence and severity of post-surgical adhesions. ^{10, 12,13}

While the cost of Seprafilm Adhesion Barrier may vary based on location, quantity and procurement contracts, it is imperative to consider this modest investment (under $500/package) against the backdrop of potential savings in postoperative care. The initial expense is counterbalanced by the potential reduction in complications associated with adhesion formation, highlighting the value of Seprafilm Adhesion Barrier from a cost-benefit perspective. For patients, the use of Seprafilm Adhesion Barrier translates into a significantly lower risk of developing post-surgical adhesions, thereby minimizing the likelihood of adhesion-related complications such as chronic pain and infertility.^{12, 13}

The primary advantage of Seprafilm Adhesion Barrier lies in its proven efficacy in reducing the incidence of post-surgical adhesions, which are among the leading causes of complications such as bowel obstructions and chronic pain following abdominal surgeries.^3,6,7 By effectively decreasing the likelihood of these complications, Seprafilm Adhesion Barrier not only enhances patient outcomes but also potentially reduces the need for subsequent adhesion-related interventions. ^6,7,14 Clinical studies have shown that the use of adhesion barriers can lead to a reduction in the rate of readmissions for bowel obstructions and other adhesion-related issues, which are both costly and resource-intensive to treat.^6,7 In addition, per the Evidence-Based Guidelines from the World of Emergency Surgery Adhesive Small Bowel Obstruction Working Group, the use of adhesion prevention/reduction agents should be considered as part of an adhesion reduction strategy.⁸ Per the recommendations outlined in these guidelines, Level IA evidence supports the use of Seprafilm Adhesion Barrier to reduce adhesion formation and subsequent reoperations of adhesive small bowel obstruction.¹⁴ They also note the use of Seprafilm Adhesion Barrier seems cost effective in open colorectal surgery.¹⁴

From an economic standpoint, any potential reduction in abdominopelvic adhesions would translate into considerable cost savings for healthcare providers based on the high costs of treating adhesion-related complications.^6,7,15,16 These savings would manifest in various ways, including fewer readmissions, reduced need for additional surgeries and shorter hospital stays. By preventing the formation of adhesions, hospitals may avoid the direct costs associated with treating these complications.⁷ Moreover, the use of Seprafilm Adhesion Barrier potentially contributes to improved operational efficiencies within healthcare facilities.⁵ By reducing the incidence of adhesion-related complications, hospitals may maintain a higher turnover of surgical beds and minimize the length of stay for patients.⁵

Beyond the direct economic benefits, the use of Seprafilm Adhesion Barrier aligns with broader healthcare objectives of improving quality of care and patient satisfaction. Direct medical costs represent only a portion of the actual cost to society represented by lost time from work, reduced productivity and lost pay.⁴ In addition, by proactively addressing a common source of post-surgical complications, healthcare providers may improve their quality metrics, such as lower readmission rates and enhanced patient outcomes. These improvements are pivotal in an era where healthcare reimbursement is increasingly tied to performance metrics and patient satisfaction scores. Facilities that adopt Seprafilm Adhesion Barrier and similar innovations demonstrate a commitment to advancing surgical care and optimizing patient experiences.