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Evaluation of Perivascular Adhesion Formation in New Zealand White Rabbits Using Oxiplex and DuraSeal Xact Adhesion Barrier System

Fred Mo, MD,1 James Yue, MD,1 Jianghui Zhang, MD,1 Kreg Howk, MS,2 Allister Williams, MD1

1Department of Orthopaedics and Rehabilitation, Yale University School of Medicine 2Covidien



Adhesion formation after spine surgery is a result of normal wound healing that may place patients at increased risk for complications during revision surgery. Preventing adhesions could reduce the risk of complications during revision surgery, and possibly reduce the need for revision procedures. This study evaluates the ability of DuraSeal Xact Adhesion Barrier System (DSX) (Covidien, Mansfield, Massachusetts) and Oxiplex/SP gel (OX) (FzioMed, San Luis Obispo, California) to affect the extent and severity of postoperative perivascular adhesion development in an anterior spinal surgical rabbit model.


We determined the extent and severity of postoperative adhesion development 34 days after surgery in 12 male New Zealand White rabbits randomly assigned to intraoperative treatment with either DSX or OX, or to an untreated control group. Adhesion severity and extent were scored on scale from 0 (none) to 3 (severe).


The extent and severity of adhesions in the DSX group were significantly less than in the untreated control group. The DSX group mean extent score was 1.3 ± 0.5 (vs 2.5, = .01) and the mean severity score was 1.25 ± 0.5 (vs 2.8, = .005). The extent and severity of adhesions in the OX group were not significantly different from the control group.


In this study, we found DSX to be the most effective compound in preventing adhesion formation after anterior spine surgery.

Clinical Relevance

Extrapolating these results in rabbits to humans, less scarring between the major blood vessels could decrease the rate of complications in revision spine procedures.

Perivascular adhesions, DuraSeal Xact, PEG hydrogel, Oxiplex, surgical sealant, adhesion barrier
Volume 3 Issue 2