1: Magy Seb
1: Magy Seb. 2003 Oct;56(5):171-6.
[Biological behavior of polypropylene meshes suitable for intra-abdominal
implantation in animal model]
[Article in Hungarian]
Baracs J, Takacs I, Shahram GS.
Pecsi Tudomanyegyetem Altalanos Orvosi Kar Sebeszeti Klinika.
baracsjoe@freemail.hu
The expected incisional hernia rate is between 11-20% after laparotomy. Using
mesh repair the results of the hernioplasty have recently improved. However the
complication of mesh implants--especially in intraperitoneal position--can be
life threatening. Additionally the appropriate mesh is expensive. We tried to
create a mesh, which can be used intraperitoneally and generates adhesion in the
abdominal wall, but keeps the intraabdominal organs adhesion free. Our
experiments were divided into four groups. In the first we used different
materials to cover the intraperitoneal side of polypropylene mesh. In the second
phase three different pore-sized meshes were compared. In the third part the
biological behavior of three different material-reduced meshes were
investigated. Based on our previous results in the last session we used only
silicone membrane protected material-reduced polypropylene meshes to cover the
abdominal defects. Our experiments have shown that intraperitoneal implant with
silicone-covered Vypro (Ethicon)/Premilene (B. Braun Medical) mesh significantly
decreases the formations of adhesion.
PMID: 15022620 [PubMed - indexed for MEDLINE]
2: Clin Exp Obstet Gynecol. 2004;31(1):39-41.
Postoperative adhesion prevention in gynecologic surgery with hyaluronic acid.
Carta G, Cerrone L, Iovenitti P.
Obstetric and Gynecology Clinic, University of L'Aquila, Avezzano Hospital,
L'Aqullia, Italy.
Despite improvements in surgical instrumentation and techniques, adhesions
continue to form after most procedures. Peritoneal adhesions develop in 60-90%
of women who undergo major gynecological operations. This adhesion formation
causes significant postoperative morbidity such as bowel obstruction (65%),
infertility (15-20%), and chronic pelvic pain (40%). OBJECTIVE: To demonstrate
the efficacy of a hyaluronic acid product (Hyalobarrier Gel) for the prevention
of adhesions in gynecological surgery. MATERIALS AND METHODS: From October 2000
to July 2002, 18 women from 26 to 41 years old (mean age 33.66) underwent
myomectomy via laparotomy as their first abdominal operation. Between August
2001 and May 2003, the patients underwent a second-look laparoscopy (7 women,
38.9%, 15 sites, 42.8%) or a second-look laparotomy (11 women, 61.1%, 20 sites,
57.1%) during which all the 35 sites corresponding to the previous myomectomies
were analyzed. During the second-look procedure the presence, localization and
severity of adhesions were evaluated using the Operative Laparoscopy Study Group
Classification (OLSG) and American Fertility Society Classification (AFSC).
RESULTS: All patients underwent a second-look laparoscopy/laparotomy and only
five of 18 (27.7%) showed pelvic adhesions in seven sites (20%) of previous
myomectomies. No adhesion was found on the previous sites of myomectomies of
pedunculated leiomyomas so, excluding those, adhesions were found in seven of 29
sites of myomectomies (24.1%). CONCLUSIONS: The present study emphasizes the
need for improved treatments to prevent adhesions, as there is no doubt that
adhesions represent one of the major causes of female morbidity.
PMID: 14998185 [PubMed - indexed for MEDLINE]
3: J Card Surg. 2003 Nov-Dec;18(6):494-9.
Next-generation hydrogel films as tissue sealants and adhesion barriers.
Bennett SL, Melanson DA, Torchiana DF, Wiseman DM, Sawhney AS.
Confluent Surgical, Inc., 101 A First Ave, Waltham, MA 02451, USA.
BACKGROUND: The development of conveniently sprayed, tissue-adherent, inert
hydrogel films has made possible the creation of novel products that can serve a
dual function, as a surgical sealant to achieve immediate hemostasis, and as a
barrier to prevent adhesion formation over time. METHODS: A sprayable, in situ
formed absorbable hydrogel film was evaluated as a tissue sealant in a
heparinized canine carotid artery graft model. PTFE grafts with leaking
end-to-side anastomoses were treated with the synthetic sealant, and hemostasis
was evaluated upon restoration of blood flow. Also, the hydrogel films were
evaluated as an adhesion barrier in a rabbit pericardial abrasion model.
RESULTS: The sprayable, in situ forming hydrogel film was shown to immediately
seal carotid-PTFE anastomoses in six of six applications. Hydrogel application
in a rabbit pericardial abrasion model resulted in a statistically significant
reduction in the number and tenacity of adhesions. CONCLUSIONS: This novel in
situ formed sprayable hydrogel film has demonstrated a dual function as an
effective tissue sealant and as an adhesion barrier in cardiovascular
preclinical models. These next generation synthetic biomaterials are currently
undergoing clinical investigations.
PMID: 14992098 [PubMed - indexed for MEDLINE]
4: J Chir (Paris). 2003 Dec;140(6):325-34.
[Post-operative bowel obstruction. Part 2: Mechanical post-operative small bowel
obstruction by bands and adhesions]
[Article in French]
Duron JJ.
Service de Chirurgie Generale et Digestive, UMR 7000, Centre Hospitalier
Universitaire Pitie Salpetriere, Paris. jean-jacques.duron@psl.ap-hop-paris.fr
Small Bowel obstruction due to post-operative adhesions is a common problem in a
general surgical practice. Any laparotomy initiates the lifelong risk of this
complication. Mortality rates have improved dramatically in the last three
decades. The basic evaluation and treatment of small bowel obstruction is well
defined but many individual strategies may result from the variety of clinical
presentations and from techniques and equipment available to a local surgical
practice. Recent advances in surgical techniques and preventive strategies may
improve overall results. Results will remain linked to the continuous aging of
the populations of Western countries.
Publication Types:
Historical Article
Review
Review, Academic
PMID: 14978440 [PubMed - indexed for MEDLINE]
5: Surgery. 2004 Mar;135(3):307-12.
Reduction in postoperative adhesion formation and re-formation after an
abdominal operation with the use of N, O - carboxymethyl chitosan.
Zhou J, Elson C, Lee TD.
Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova
Scotia, Canada.
BACKGROUND: Postoperative adhesions have proven to be intractable complications
after abdominal operations. This study assessed the efficacy of N, O -
carboxymethyl chitosan (NOCC) to limit adhesion formation and re-formation in a
rabbit abdominal surgery model. METHODS: In study 1 (adhesion formation),
injuries to the large bowel, cecum, and abdominal sidewall were generated in
rabbits. The rabbits (10/group) were randomly assigned to 1 of 5 treatment
groups: Group A received no NOCC treatment; in group B, NOCC gel was applied
directly to the injured site and NOCC solution was applied throughout the
abdominal cavity; in group C, NOCC gel was applied near the injured site and
NOCC solution was applied as above; in group D, NOCC gel was applied distant to
the injury and NOCC solution was applied as above; in group E, a mixture of NOCC
gel and solution was applied at the injured site. Adhesions were evaluated 14
days later. In study 2 (adhesion re-formation), adhesions were generated as
above but were then lysed by careful dissection. After adhesiolysis, the rabbits
(9/group) were treated with NOCC gel and solution at the site of adhesiolysis or
left untreated. Adhesion re-formation was assessed 14 days later. In study 3
(mechanism of action), sterile tissue culture plates were coated with NOCC and
adhesion of cultured, radiolabeled murine fibroblasts to the plates was
assessed. RESULTS: In study 1, animals treated with NOCC gel and solution showed
reduced adhesion formation (P ................
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