The use of hyaluronic acid/carboxymethyl cellulose (HA/CMC) membrane, reduces the incidence, extent and severity of adhesions in the abdomen.

Adhesions in the abdomen cause abnormal bonding between adjacent peritoneal surfaces and are common after operations in the abdomen. They are composed of fibrous tissue but also contain blood vessels, fat and nerves. They result in a spectrum of problems that affect the patient (intestinal blockage, infertility and possibly pain); the surgeon (difficulties in access and dissection, prolongation of operative time, increase in blood loss, predisposition to bowel injury); the health care provider (increased cost due to readmissions and litigation). Prevention is the key. This review focus on the evaluation of the safety and efficacy of two preventive agents applied in the abdomen during general surgical operations, Hyaluronic acid /carboxymethyl cellulose membrane and 0.5% ferric hyaluronate gel.
There is evidence to suggest that use of Hyaluronic acid/carboxymethyl cellulose membrane reduces the incidence, severity and extent of adhesions.However, it does not reduce the incidence of subsequent intestinal obstruction or need for surgery to treat the obstruction, when it occurs. It appears to be safe with no significant increase in adverse effects or deaths when compared to control. There is limited data on 0.5% ferric hyaluronate gel with only one study available. This study did not report on the efficacy of the gel as it was prematurely terminated because of a significantly higher rate of adverse effects in the patients who were treated with this gel.