Impact of surgical adhesion barrier on significant adhesion during a repeat cesarean section
Background: Post-cesarean adhesions are associated with delayed infant delivery and infertility. In this retrospective study, we analyzed the effects of hyaluronic acid-carboxymethylcellulose (HA/CMC) membranes on postoperative adhesion during cesarean section. Methods: Sixty-seven patients were divided into the surgical adhesion barrier used (n = 28) and not-used group (n = 39). We compared the severity of adhesion at the repeat cesarean section, as well the following variables: operation and incision delivery time, blood loss, and postoperative infection between both groups. The severity of adhesion was analyzed using the Zühike’s adhesion score between the abdominal wall and uterine corpus, and the Steinleitner’s uterine adhesion score. Results: We found that the Zühike’s adhesion score between the abdominal wall and corpus of the uterus in the surgical adhesion barrier used group was significantly lower than that of the not-used group (0.46 ± 0.2 and 1.0 ± 0.2, respectively) (p = 0.04). The Steinleitner’s uterine adhesion score of the surgical adhesion barrier used group was lower than that of the not-used group (0.5 ± 0.3 and 1.3 ± 0.3, respectively), but not significantly (p = 0.07). Discussion: We concluded that the surgical adhesion barrier was effective in preventing postoperative adhesion formation during cesarean sections. However, further investigations are necessary to reveal the usefulness of the surgical adhesion barrier during cesarean section, including its cost-effectiveness.