{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:49:38Z","timestamp":1791888578495,"version":"4.3.4"},"reference-count":62,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy and safety of adhesion barriers in preventing postoperative adhesions remain uncertain. This systematic review and meta\u2010analysis aimed to evaluate the effectiveness and safety of adhesion barriers in reducing postoperative adhesions following abdominopelvic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CENTRAL, EMBASE and MEDLINE were searched from inception to January 15, 2025 for parallel\u2010arm randomized controlled trials (RCTs) comparing adhesion barriers with controls in patients undergoing abdominopelvic surgery. Case series, case reports, reviews, animal studies, observational studies and studies involving patients with pre\u2010existing adhesions were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010six RCTs involving 6729 patients were included. Adhesion barriers significantly reduced the incidence of postoperative adhesions on second\u2010look assessment compared with controls (21 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a02351; OR 0.37, 95% CI 0.30\u20130.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a051%; certainty of evidence: moderate). Subgroup analyses demonstrated significant reductions in postoperative adhesions in both general surgery (9 studies,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01162; OR 0.38, 95% CI 0.27\u20130.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a027%) and obstetrics and gynecology (12 studies,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01189; OR 0.36, 95% CI 0.27\u20130.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a062%). Pooled analysis demonstrated no significant differences between the adhesion barrier and control groups in the incidence of anastomotic leakage (9 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01541), abscess formation (6 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01182), wound infection (11 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01084), time between initial surgery and second surgery (10 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0874), intraoperative blood loss (15 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a05327) and adhesion severity (11 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0756). Adhesion barriers were associated with a modest reduction in post\u2010operative small bowel obstruction (12 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04917; OR 0.81, 95% CI 0.66 to 0.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a038%), but were associated with a significantly longer duration of the index operation (18 RCTs,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a05868; MD 18.66, 95% CI 11.25 to 26.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a099%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adhesion barriers reduced adhesions at second\u2010look assessment in a meta\u2010analysis of pooling eight heterogeneous agent classes and procedures against an inconsistently scored surrogate outcome. Thus, evidence remains insufficient to recommend routine use or to define which patients, procedures, or risk levels warrant its use. Until adequately powered, agent\u2010specific trials with standardized scoring and patient\u2010centered endpoints exist, adhesion\u2010barrier use should remain an individual clinical decision, not standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration<\/jats:title>\n                    <jats:p>CRD42024595564<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70606","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:22:07Z","timestamp":1791886927000},"source":"Crossref","is-referenced-by-count":0,"title":["The Use of Adhesion Barriers in Abdominopelvic Surgery: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0638-1222","authenticated-orcid":false,"given":"Paul Van Siang Lian","family":"Mang","sequence":"first","affiliation":[{"name":"Queen Elizabeth University Hospital  Glasgow Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7725-520X","authenticated-orcid":false,"given":"Hui Jun","family":"Chuen","sequence":"additional","affiliation":[{"name":"College of Medical, Veterinary &amp; Life Sciences Queen's University Belfast  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7825-2628","authenticated-orcid":false,"given":"Ka Ting","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Faculty of Medicine Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800760422"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2017.01.021"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010010\u20100778\u20108"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6742"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2000.tb11083.x"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010010\u20101189\u20108"},{"key":"e_1_2_13_8_1","first-page":"49","article-title":"The Role of Seprafilm Bioresorbable Membrane in Adhesion Prevention","volume":"577","author":"Beck D. 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