Effects of a Hyaluronate-Carboxymethylcellulose Membrane (Seprafilm) on Human Polymorphonuclear Neutrophil Functions

Background: Seprafilm (Genzyme Corp., Cambridge, MA) is safe and effective for reducing adhesion formation in abdominal and pelvic surgery. However, the relationships between Seprafilm and postoperative complications, including intra-abdominal abscess formation and intra-abdominal inflammation, remain controversial. Polymorphonuclear neutrophils (PMNs) play crucial roles in the processes of intra-abdominal inflammation, infection, and abscess formation, and PMNs act as the first line in nonspecific host defense against a wide range of pathogens. The present study evaluates the effect of Seprafilm itself on human PMNs in experimental models in vitro. Materials and methods: Human PMNs were isolated from blood samples obtained from 14 healthy volunteers. The functions of the isolated cells were assessed by examining their phagocytosis, apoptosis/necrosis rates, cytokine production, and PMN-elastase release with and without Seprafilm in an in vitro experimental model of inflammation and endotoxin-stimulation. Results: There were no significant differences in the PMN phagocytosis, apoptosis/necrosis rates, cytokine production, or PMN-elastase release into the supernatant after coculture with bacteria between assays with and without Seprafilm. In the PMN stimulation models involving tumor necrosis factor-alpha and lipopolysaccharide, there were no significant differences in cytokine production between assays with and without Seprafilm. Furthermore, a similar experiment measuring cytokine production in the presence of well-dissolved Seprafilm produced corresponding results. Conclusions: Our results suggest Seprafilm itself does not affect the functions of isolated human PMNs in in vitro experimental models of inflammation and endotoxin-stimulation.