Introduction
During surgical healing, tissue adhesions may develop due to factors such as trauma, bleeding, and inflammation. Postoperative adhesions not only cause complications such as chronic pain, intestinal obstruction, and infertility, but can also pose long-term medical risks and cost burdens for patients. To mitigate this risk, surgical adhesion barriers are increasingly being adopted as a preventative measure, particularly in the abdominal, pelvic, gynecological, and general surgery fields. This article will systematically introduce their types, mechanisms of action, and product advantages, with a focus on ideal adhesion barrier gel.
Types of Surgical Adhesion Barriers
Currently, common surgical adhesion barriers on the market can be classified based on material form or mode of action. The following are the main types:
|
Types |
Main Features |
Advantages |
Limitations/Notes |
|
Films / Sheets |
An absorbable membrane placed between tissues |
Good physical isolation effect and clear positioning |
The operation is more complicated; it is not easy to cover complex structures or concave and convex surfaces |
|
Foams / Sponges |
Porous structure, can be soaked in physiological fluids |
Adapts to concave surfaces and remains moist |
May require pre-wetting or squeezing to adhere to tissue |
|
Gels |
Flowable material, can be injected or coated |
Uniform coverage, easy operation, and the ability to enter small gaps |
Need to ensure residence time and dosage control |
|
Powders |
Dry powder or microgranule form |
Easy to store and transport |
Re-film formation in water or body fluids may be uncertain |
Many modern products tend to be gel/liquid based due to their inherent advantages in handling and coverage, especially within complex abdominal or pelvic structures.
How It Works: Mechanism of Action
To understand how the adhesion barrier functions, we first need to briefly understand the biological processes of postoperative adhesions:
Trauma and Inflammatory Phase
Surgical procedures cause tissue damage, bleeding, and exudate, triggering an inflammatory response.
Fibrin Network Formation
The plasma protein fibrin deposits at the wound site, forming a sticky network.
(If not cleared) Fibrosis and Cellular Infiltration
If this fibrin layer is not dissolved/fibrinolyzed, fibroblasts, blood vessels, and collagen enter, gradually transforming it into irreversible fibrous tissue (adhesion tissue).
Adhesion Formation
Adjacent tissues (such as the intestine, abdominal wall, uterus, and ovaries) may adhere to each other due to these fibrous connections, affecting their structure and function.
Adhesion barrier materials serve to create a temporary barrier between injured tissues, maintaining separation during the critical early postoperative period (usually a few days to a week). This helps:
Prevent or delay fibrin bridging between tissue surfaces
Give the body time to clear fibrin through its own fibrinolytic system
Prevent cross-tissue invasion by cells, blood vessels, and fibroblasts
Specific mechanisms
Physical barrier: The material temporarily separates the two tissue surfaces
Promotes fibrinolysis: Some materials (such as hyaluronic acid) may promote plasmin/fibrinolytic activity
Inhibits adhesion factors: Reduces the effects of intercellular adhesion molecules
Biopeptide/biodegradable: The material is naturally degraded in the body when necessary, leaving no foreign material.
During this process, the material's absorption and degradation time must be aligned with the rate of wound repair: long enough to provide a barrier, but not too long to interfere with normal tissue remodeling.
Adhesion barrier materials serve to create a temporary barrier between injured tissues, maintaining separation during the critical early postoperative period (usually a few days to a week). This helps:
Prevent or delay fibrin bridging between tissue surfaces
Give the body time to clear fibrin through its own fibrinolytic system
Prevent cross-tissue invasion by cells, blood vessels, and fibroblasts
Advantages & Key Considerations
The following are typical advantages of high-quality adhesion barrier products, as well as key parameters to consider when selecting one:
Good Biocompatibility / Low Immunogenicity: It is best to choose materials that are similar to natural substances in the human body or that can be degraded by enzymes to reduce immune responses or inflammatory stimulation.
Completely Degradable / No Residue: The product should be completely degraded and metabolized in the body, leaving no long-term foreign matter.
Suitable Degradation / Absorption Time: The optimal absorption period is generally several days to a week, covering the early stages of adhesion formation without delaying healing.
Good Coverage / Flowability: Can cover irregular surfaces, gaps, and porous structures, and is easy to use.
Safety / Non-Pyrogenic / Non-Toxic: Used under sterile conditions, it cannot contain pyrogens, endotoxins, or other harmful substances.
Ease of Use: Injection, application, and infusion are all convenient, and they do not significantly increase surgical time.
Regulatory Certification/Quality System Assurance: Certifications such as CE, ISO, or compliance with relevant medical device regulations, can help distributors and hospitals gain acceptance.
When selecting barrier materials, factors such as cost, supply stability, packaging format, and dosage form should also be considered.
Product Example: Singclean Adhesion Barrier Gel
Singclean's Anti-adhesion Barrier Gel (Adhesion Barrier Gel by Singclean) is a product worth highlighting.
This product is composed of sodium hyaluronate (sodium hyaluronate) and a physiologically balanced salt solution. It lacks sulfate groups and is not covalently bound to proteins. It exists in the body as a "free chain," providing lubrication, moisturizing, and mechanical isolation.
It has excellent biocompatibility, low immunogenicity, and is non-toxic. It is also biodegradable and absorbable in the body.
Its degradation time is optimally designed: if the degradation period exceeds 7 days, it may interfere with peritoneal wound repair. Singclean has optimized its formula to ensure that it degrades within an appropriate timeframe.
Product Advantages
Safety and Non-Immunogenicity: produced using a fermentation method, it avoids viral vector risks, and its structure contains no sulfate groups, minimizing immune stimulation.
Completely Biodegradable / No Residue: enzymatically degrades in the body, ultimately eliminating it completely and eliminating the risk of long-term residues.
Suitable Degradation Time: designed with a degradation time of ≤ 7 days, it ensures both early isolation and wound repair.
Multiple Sizes Available: a variety of sizes (such as 1 mL, 2 mL, 3 mL, 5 mL, 10 mL, and 20 mL) are available to accommodate varying surgical areas.
Certifications and Partnerships: the product holds CE and ISO quality certifications.