0000000000075214
AUTHOR
Constanze Planck
Intraperitoneal adhesions-an ongoing challenge between biomedical engineering and the life sciences
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…
A pilot study of laparoscopic adhesion prophylaxis after myomectomy with a copolymer designed for endoscopic application.
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…
A Direct Comparison of Seprafilm, Adept, Intercoat, and Spraygel for Adhesion Prophylaxis
Background Commercially available agents for adhesion prophylaxis are legion but there is a lack of direct comparisons between them. Here we compare four of the most commonly used adhesion barriers against a control group in a clinically relevant rat model. Material and Methods Standardized lesions were created in Wistar rats using electrocautery and suturing. Subsequently, the experimental lesions were treated with Seprafilm (n = 30), Adept (n = 30), Intercoat (n = 30), Spraygel (n = 30), or no barrier (n = 30). The resulting adhesions were examined 14 d postoperatively. Results The mean area covered by adhesion was 77% in the control group, 46% in animals treated with Seprafilm, 54% in an…