Pain and visible scarring are part of the common surgery equation, but sometimes the worst scars go unseen to the naked eye.

Adhesions are internal scars or fibrous bands of scar tissue that bind normally unconnected parts of tissue together. Adhesions can be present from birth, but they are normally caused as the body tries to repair itself following inflammation or infection after surgery, trauma or radiation.

Adhesions emerge as thin sheets of tissue comparable to plastic wrap or as a thick fibrous substance. People who have adhesions can have difficultly going to the bathroom, bowel blockage or discomfort in non-specified areas. The most common areas for adhesions are the abdomen, pelvis and heart, but they can occur anywhere.

The internal scars usually form within the first couple of days after surgery, but sometimes symptoms do not show up for months or even years. Many times, the condition goes undiagnosed.

Adhesions restrict the free movement of internal organs and may cause an interior pain to be felt. Most of the time pain occurs because the adhesion is pulling on nerves within the tied down organ or within the adhesion itself. Doctors recommend getting X-rays, CT scans or an ultrasound to help with the diagnosis.

Symptoms of adhesions include chronic abdominal pain, bloating, vomiting, constipation, diarrhea and obstruction. Prior to the new treatments that exist today, surgeons would have to operate to cut the scar or patients would live with the pain. The problem with multiple surgeries is that even after the scar is cut, it can come back and an unnecessary cycle of surgery continues.

Today, there is a new product that helps with prevent adhesion formation in patients who have abdominal or pelvic laparotomy. Seprafilm is comprised of chemically modified sugars, some of which the human body makes naturally. The drug is delivered in a clear film about three to five inches in size that transforms into a gel once it enters the body. The body rids of it after about one month.

Seprafilm works as a physical barrier that separates tissue surfaces as the body's natural healing process takes place. As a preventive measure, doctors place Seprafilm on areas where they expect scarring to occur. It appears to be the first truly successful absorbable adhesive. Both surgeons and patients say they can easily see the value in this treatment; it can prevent reoperation, which decreases the number of adhesions and also prevent unnecessary bowel obstructions and pain for patients.

"I think it's a great product," said Dr. Gerald Feuer, a gynecological oncologist at Southeastern Gynecologic Oncology, Inc. in Atlanta. "I use it on every single patient I can. I am a true believer in it."

A study done by Genzyme, the company that makes Seprafilm, revealed patients who were treated with the drug after colon surgery were 8.5 times more likely to be adhesion-free than those who received no adhesion barrier. The adhesions in the patients that did develop them were less and smaller than those not treated with the drug.

Additional Resources:

Southeastern Gynecologic Oncology, LLC
Seprafilm Adhesion Barrier