Radovan Vlk, Martina Velíšková, Petra Hanulíková, Jan Matěcha
The incidence of caesarean section is increasing constantly in most of the European countries which inevitably leads
to a larger number of related complications. In addition to perioperative and early postoperative complications, longterm
consequences of caesarean sections are becoming more of an interest to medical practitioners. Somewhat marginalized
is the issue of postoperative adhesions. After any abdominal surgery, adhesions may form as a natural part of
the body healing process. The rate of adhesion formation after caesarean sections has been reported in the literature
as relatively high (at least 25 %). The adhesions may become a source of both early and chronic pain as well as negatively
affect bowel movement, reducing a patient’s odds of conceiving and furthermore complicate a repeated caesarean
section. Adhesion prevention consists firstly of adherence to the proper surgical techniques and secondly of application
of anti-adhesive agents. Hyalobarrier gel belongs to the excellently tolerated and completely biodegradable substances.
Its efficacy in abdominal surgery has been confirmed by several studies. The authors provide a review of the
literature together with their own experience with the use of Hyalobarrier gel in caesarean sections. Results of the pilot
study confirm efficacy, safety of use and good patient compliance. Three to six months post-surgery, pain in pelvic
and abdominal regions was non-existent or minimal according to patient reports. Ultrasound examination six months
post-surgery did not show any negative impact on the uterine scar healing. The results of the study support Hyalobarrier
gel as a rational and meaningful choice in the spectrum of premium obstetric care.