Hello all, Anyone have links to studies (if any) on seprafilm? How about similar products? My father has horrible adhesion from previous small bowel surgery. They are causing a blockage (lower intestine). He can barely eat and live a normal life. None of the docs in my area seem to use this stuff. I'm just looking for some options for him as he might just have surgery again. Docs are telling him he will feel fine for a couple years but more than likely will have adhesions come back. Any recommendations for surgeons in Denver area?
There are a number of articles listed on PubMed for Seprafilm: http://www.ncbi.nlm.nih.gov/pubmed/?term=seprafilm On the left side of the screen, under the header "Article Types", click "More" Now select "Reviews" and "Meta-Analysis." This will add these two filter options under the "Article Types" header. Click on one or the other to see the results that come up. Hopefully these will be of help to you. If full text is not available online, you may need to write down the article's information and take it to a university or college library. As for finding a surgeon who actually uses Seprafilm...good luck. The majority of surgeons in the U.S. do not use any kind of adhesion barrier. It's unfortunate as the technology is relatively cheap. And though no barrier can be 100% effective, a *somewhat* effective barrier is better than nothing. You'd think insurance companies would demand that barriers are used, but I guess they enjoy paying for more surgery down the road, or they are just as clueless as the medical community. Maybe try contacting the manufacturers of Seprafilm? Maybe they can help direct you to a surgeon who uses their barriers. http://www.seprafilm.com/ There are other barriers on the market as well (check out https://en.wikipedia.org/wiki/Adhesion_barrier to learn more.) You can follow all of the above steps for each one. I wish you the best of luck. It's a shame how advanced modern medicine is and yet still so far behind what it *could* and should be. Well wishes to your father.
wow!!! thank you for taking the time to respond! greatly appreciated!! funny you say that many surgeons do not use barrier prevention, so true. I have talked to many of the general surgeons in my area and none have ever brought it up. maybe I need to throw it out there to them. Again, a big THANK YOU, THANK YOU, THANK YOU!!!!
To the person who posted the first answer, hats off to you. this site is so full of people who just bs. one of the best responses I have read on cafepharma. we need more people like you on here, just simply willing to help out. to the OP, I read your post and wish you and your father the best.
Did you find the general surgeon to do your father's surgery or did you get him assigned by the hospital or thru your insurance? At least from my experience with dealing with my wife's OB when she was going to have her 2nd C-section, i told the OB i wanted Seprafilm used. He squabbled a bit and said "he never gets adhesions" which i laughed and said he really has nothing to do with whether adhesions form or not unless he also really botches the closure. Kept looking him in the eye and said, again, i want an adhesion barrier used. So with your surgeon, you can tell him that your father is already known to be high risk, and that you want to do something about it. He can dispute the clinical evidence and efficacy of Seprafilm if he wants but you can point to him that it is an approved product, and there is evidence suggesting it works. Now beyond this, and now an area that i don't know how it would register with a doc, is to tallk about liability. You indicate that your father has a history of complications, you requested additional measures be taken to help reduce further complications, and you put it all on record, now the surgeon is in a tricky position. But again, never had to try that type of motivating factor bottomline, the hospitals give the surgeons the hard time about using these products. They don't stock them, or heavily restrict their use. let us know how it works out
Thank you!!! The general surgeon was one that many recommended. I'm not sure if seprafilm has ever been implanted in my father. I'm going to have him call his surgeons and check. He's had surgery from I think 3 different docs. I'm just so tired of seeing him live like this. I'll do anything to help him hopefully have a better outcome if he does decide to have another operation. I really appreciate all the help/info everyone!!!
To the OP. I have had seprafilm implanted in me - twice. I work in med device sales and I see all sorts of specialities and I don't let anyone but well vetted surgeons work on me/my family. After a 10 year battle with ulcerative colitis I had my colon removed last year. About a foot of rectum was left to enable a J pouch in a subsequent surgery. The surgeon placed two sheets of seprafilm around the rectal stump. 8 weeks ago I had the remainder of my rectum removed as it was so diseased I couldn't live with it anymore. The surgeon also used seprafilm to pack my lower pelvis. The rectal specimen was noted by pathology to have "giant foam cell infiltration indicative of foreign body reaction". I have photos showing where the seprafilm was placed on the rectal specimen and the foreign body reaction was at this location. My surgery was hand-assisted so the seprafilm was placed by hand, not the laparascopic slurry. On post op day 11, after my most recent surgery, I developed a high fever with lower abdominal pain, and went to the ER where I was found to have ileus, elevated WBC, and over half a liter of fluid collection in the pelvis. I was admitted for 5 days until ileus resolved and WBC was near normal. Suspected severe inflammatory reaction to seprafilm. On post op day 21 a large collection of blood and serous fluid suddenly drained through my rectal staple line while I was sleeping. Very scary to see that volume of bloody fluid at 2am. After two weeks of conservative treatment at home my fluid collection abscessed and became infected. I was now passing pus every couple hours. Antibiotic treatment cleared it up but I'm back to blood now. My rectal staple line is obviously compromised and I may have to have an APR (abdomnioperineal resection) in the near future if it doesn't collapse and scar down. That means permanent ileostomy. I still have a moderately reduced pelvic fluid collection as of 9 weeks post op as determined by CT scan. Go to this link, as it explains everything and is very well cited. view as pdf and download. http://www.citizen.org/hrg2266 That group recently petitioned the FDA to remove seprafilm from the market. Look at the potential adverse events - I fit about 70% of them. My colorectal surgeon filed an adverse event report and is never using seprafilm again. Good luck to you and your father.
