I asked my friend Karen who is a surgical PA about methods to prevent adhesions recently, but my questions were specific to adhesion barriers that some surgeons use (perhaps not so much in the spinal world). Some of the excerpts below may provide insights on the original question.
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I finally saw the surgeon I had wanted to ask about the adhesion film. He said there have been no long term studies on it because determining if it actually cuts down on small bowel obstructions requires following people for too many years to be feasibly possible. You can have one abdominal operation at age 30, get adhesions and not get a bowel obstruction from it until you are 80. He said that what has been shown though is that people that have needed re-operations on their abdomens for various reasons did have a markedly reduced amount of adhesions compared to people that the film was not used in. Less adhesions theoretically translates into less possibility for small bowel obstructions in the future.
He also said it has virtually no risk since it is biodegradable and gets completely broken down by the body. It does its work immediately following surgery at the time adhesions would be forming, and then dissolves.
So if the surgeon uses it I would probably request that he put it in. Wouldn't hurt. That's what this particular surgeon advised. I like him not only because he's an excellent surgeon, but because he follows the research pretty well and thinks about things very logically from a risk/benefit perspective and he's very practical.
From a follow-up email on this original post, also from Karen:
If someone is in a lot of pain, vomiting and not having bowel movements or passing gas, then they may have a complete bowel obstruction which is what the guy she saw was eluding to. You can have a partial obstruction with some symptoms, some pain, bloating, constipation or actually some diarrhea sometimes. Can certainly be on and off as well. The workup is to have a KUB x-ray and then do a barium swallow with small bowel follow up films. If that is suggestive, the doc would usually then proceed with an abdominal CT with contrast to drink. If partial small bowel obstruction is suspected the person to see is a general surgeon, after perhaps your PCP to start the workup.
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Judy, how are you doing?
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