Search results for "Tissue Adhesions"
showing 10 items of 20 documents
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…
Remodeling of peritoneal-like structures by mesothelial cells: its role in peritoneal healing.
1999
Abstract Background. Intraabdominal adhesions are a common complication following laparotomy. Since the exact mechanisms involved in this processes are unknown we have analyzed in vitro the role of mesothelial cells in peritoneal healing. Material and methods. Human mesothelial cells from omental tissue were cultivated for 2 weeks in a three-dimensional culture either on or in a collagen type I matrix. The effects of blood and collagen matrix were analyzed by exposing mesothelial cells to an overlying blood clot, simulating intraperitoneal bleeding, or a second collagen layer. The production of collagen types III and IV, fibronectin, and laminin was analyzed with immunohistochemical methods…
Laparoscopic surgical management of localized recurrent ovarian cancer: a single-institution experience
2014
Background: Optimally, secondary cytoreduction is acknowledged as a valid option in terms of oncologic outcome for patients with platinum-sensitive recurrent ovarian cancer. In cases of localized relapse, a laparoscopic approach has been attempted at various institutions, but studies on its role for this subset of patients still are limited. This report describes the authors' experience using laparoscopic secondary cytoreduction for patients with localized recurrent ovarian cancer. The results from a retrospective analysis of a prospective case series are reported. Methods: Between October 2011 and May 2013, 29 patients with localized recurrent ovarian cancer were selected for a laparoscopi…
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…
Computed tomography of bowel obstruction: Tricks of the trade
2015
Bowel obstruction (BO) is a frequent cause of hospitalization and surgical consultation for acute abdominal pain. It is usually suspected at physical examination, but clinical and laboratory data are often nonspecific. Thus, computed tomography plays a crucial role in a correct diagnosis of BO. Indeed, computed tomography can confirm a diagnosis of BO, and identify the location and cause of the obstruction. In this review, the computed tomography appearances of common and uncommon causes of BO and pseudo-obstruction are reviewed.
Intra-operative locally injected pharmacotherapy as a novel strategy for adhesion prophylaxis.
2012
Abstract Background Pharmacotherapy for peritoneal adhesion prophylaxis has been a focus for intensive research. Previous strategies included intravenous and intraperitoneal application of suitable pharmaceutical agents. However, success of these strategies in humans has been limited. Here we describe intra-operative local injection of pharmaceuticals as a novel strategy for adhesion prophylaxis. Methods N = 208 peritoneal lesions were created in 26 adult Wistar rats. In each animal, lesions on one flank were randomly chosen for treatment with locally injected prednisolone whereas the contralateral side was injected with normal saline. Half of the animals were randomly selected for early a…
Prevention of intrauterine post-surgical adhesions in hysteroscopy. A systematic review
2016
Abstract Objective The purpose of the present review is to provide a survey of the various measures of preventing adhesions used in hysteroscopic surgery. Study Design A systematic computerized literature search was conducted to provide a survey of the various measures used in hysteroscopic surgery to prevent adhesions. Finally, 29 studies were included in the analysis, showing a wide variety of methods and agents advocated in international literature. They are explained in various sections, based on the IUA prevention approach adopted (surgical technique, early second-look hysteroscopy, barrier method, pharmacological therapy). Results The results of our review show that (i) use of surgica…
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 Direct Comparison of Seprafilm, Adept, Intercoat, and Spraygel for Adhesion Prophylaxis
2010
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…
The extent of adhesion induction through electrocoagulation and suturing in an experimental rat study.
2008
Objective To investigate the effect of three types of peritoneal trauma occurring during surgery (high-frequency bipolar current, suturing, and mechanical damage) on postoperative adhesion formation in a rodent animal model. Design Randomized, controlled experimental trial in an in vitro animal model. Setting Laboratory facilities of a university department of obstetrics and gynecology. Animal(s) Thirty-five female Wistar rats. Intervention(s) Bilateral experimental lesions were created on the abdominal wall in every animal. The effect of minimal electrocoagulation was examined by creating lesions (n = 14) through sweeps of a bipolar forceps with a duration of 1 second and standardized pres…