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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