0000000000075213
AUTHOR
Helmut Hierlemann
showing 6 related works from this author
Intraperitoneal adhesions-an ongoing challenge between biomedical engineering and the life sciences
2011
Peritoneal adhesions remain a relevant clinical problem despite the currently available prophylactic barrier materials. So far, the physical separation of traumatized serosa areas using barriers represents the most important clinical strategy for adhesion prevention. However, the optimal material has not yet been found. Further optimization or pharmacological functionalization of these barriers could give an innovative input for peritoneal adhesion prevention. Therefore, a more complete understanding of pathogenesis is required. On the basis of the pathophysiology of adhesion formation the main barriers currently in clinical practice as well as new innovations are discussed in the present r…
Semiautomated quantification of the fibrous tissue response to complex three‐dimensional filamentous scaffolds using digital image analysis
2021
Fibrosis represents a relevant response to the implantation of biomaterials, which occurs not only at the tissue-material interface (fibrotic encapsulation) but also within the void fraction of complex three-dimensional (3D) biomaterial constructions (fibrotic ingrowth). Usual evaluation of the biocompatibility mostly depicts fibrosis at the interface of the biomaterial using semiquantitative scores. Here, the relations between encapsulation and infiltrating fibrotic growth are poorly represented. Virtual pathology and digital image analysis provide new strategies to assess fibrosis in a more differentiated way. In this study, we adopted a method previously used to quantify fibrosis in visc…
Innovative barriers for peritoneal adhesion prevention: liquid or solid? A rat uterine horn model.
2005
Objective To compare the effects of solid barriers (PDLA membrane and foil, Interceed), innovative barrier solutions (Adept and Hyalobarrier Gel, phospholipid emulsion), and Ringer’s lactate solution in preventing postsurgical peritoneal adhesions in the rat. Design Prospective, randomized experimental study. Setting Rat model in an academic research environment. Animal(s) Female, nonpregnant Wistar rats. Intervention(s) Standardized surgical injuries were applied to the parietal and visceral peritoneum and the uterine horns. The barrier agents were applied and the wound was closed. A second-look laparoscopy was performed 31 days after surgery to assess adhesion formation. Main Outcome Meas…
A pilot study of laparoscopic adhesion prophylaxis after myomectomy with a copolymer designed for endoscopic application.
2009
Abstract Study Objective To assess the laparoscopic handling and safety of D,L-polylactide-e-caprolactone-trimethylene carbonate (PCT) copolymer after myomectomy and compare it with icodextrin. In contrast to previously developed solid barriers, the material has rationally designed properties that are advantageous for convenient laparoscopic application. Design A randomized, single-blinded clinical study (Canadian Task Force Classification I). Setting Single-center study in a German University Hospital. Patients Thirty patients who underwent laparoscopic myomectomy were enrolled. Interventions After laparoscopic myomectomy and subsequent reconstruction of the uterus with interrupted sutures…
Adhesion prophylaxis using a copolymer with rationally designed material properties.
2008
Physical barriers are the only licensed adjuncts for adhesion prophylaxis in the United States and Europe. Here, we investigate D,L-polylactide-epsilon-caprolactonetrimethylenecarbonate (PCT copolymer), which is a rationally designed biomaterial, as an adhesion barrier.PCT copolymer membranes were produced by polymerization of the monomers, dissolution in organic solvents, and subsequently processing them by means of modified phase inversion and freeze drying. In vitro cytotoxicity was assayed by fibroblast culture. In vivo adhesion prophylaxis was studied in a rat model that involved standardized traumatization by electrocautery and suturing. The quantity and quality of the resulting adhes…
Tissue response to five commercially available peritoneal adhesion barriers-A systematic histological evaluation
2017
Separating wounded serosa by physical barriers is the only clinically approved adjunct for postoperative adhesion prevention. Since the optimal adhesion barrier has not been found, it is essential to improve our pathogenic understanding of adhesion formation and to compare the effects of different barrier materials on tissue and cells. Wistar rats underwent standardized peritoneal damage and were treated either with Seprafilm, Adept, Intercoat, Spraygel, SupraSeal or remained untreated as a control. 14 days postoperatively, the lesions were explanted and histomorphologically analyzed using the European ISO score to evaluate material implants. Striking differences between the material groups…