The antiadhesiogenic product composed of sodium hyaluronate and carboxymethylcellulose (Seprafilm) has been shown to be effective in reducing postoperative scarring and adhesions in body parts including the abdomen, pelvis, and during other orthopedic procedures. The goal of this study was to evaluate the safety of Seprafilm in proximity to nerve tissues in a rat sciatic model.
Seprafilm was examined in two phases: a non-injury phase, (phase I) where the material was placed superficial to the nerve or circumferentially wrapped around the nerve and an injury phase, (phase II) where the sciatic nerve was cut and then similarly exposed to the product. The animals underwent functional walking tract analysis. Histomorphometric analysis was also performed. The results did not show short or long-term deleterious effects from placing Seprafilm in proximity to peripheral nerve tissues or when it was used following a nerve transaction and repair. Walking track analysis in the injury model was similar with and without Seprafilm. The quantitative histomorphometic analysis did not reveal improvement in nerve regeneration based on this model.
Extraneural scarring and adhesion formation following peripheral nerve surgery can result in chronic compression injury and loss of normal nerve glide. To overcome this challenge, many investigators have searched for biosynthetic materials or techniques that may reduce postoperative adhesions. This report tested the safety of Seprafilm (which is commonly used in other body areas) in nerve surgery. No deleterious effects were noted with Seprafilm use and the authors could not assert improvement in nerve regeneration. However, no quantitative rating was performed for perineurial scar tissue, which may be the real benefit of this product.