Postoperative adhesion prevention

The use of combinations of HA-Na and nonsteroidal antiinflammatory drugs (e.g., naproxen sodium, tolmetin sodium), antimitotic agents (e.g., trapidil), and cytokines (e.g., interleukin-4) for preventing postoperative adhesion is discussed in more detail in Chapter 9. 

This study is designed to compare the effect of ftie gel-former selected in Section 13.3.4.2 on POA wifti a size 6-0 silk suture/saline, HA, and C-TA as basic barrier and positive controls, respectively. The adhesion formation was studied using a rat sidewall model. The abdominal cavity was entered into in female Sprague-Dawley rats through a small midline incision. A 1-cm2 area of peritoneal sidewall was excised wifti a scalpel blade. The 6-0 silk was then sutured aroimd the perimeter of ftie excised area with a square knot at each corner. Aliquots of either the gel-former (100 pL) or the controls (1 mL) were injected on tiie excised site. One week postoperative, the adhesion prevention score was recorded for the different formulations on a scale of 0 to 10. A score of 10 represents maximum adhesion whereas 0 reflects the absence of any adhesions. Adhesion rating criteria were based on the work by Bums et al. ... 

Saltzman, A. K., Olson, T. A., Mohanraj, D., Carson, L. F. and Ramakrishnan, S., Prevention of postoperative adhesions by an antibody to vascular permeability factor/vascular endothelial growth factor in a murine model. Am. J. Obstet. Gynecol., 174(5), 1502, 1996. 

Nordic Adhesion Prevention Study Group, The efficacy of Interceed(TC7) for prevention of reformation of postoperative adhesions on ovaries, fallopian tubes, and fimbriae in microsurgical operations for fertility a multicenter study, FertU. Steril., 63, 709, 1995. 

Connors R C, Muir J J, Liu Y, Reiss G R, Kouretas P C, Whitten M G, Sorenson T K, Prestwich G D and Bull D A (2007), Postoperative pericardial adhesion prevention using carbylan-sx in a rabbit model , J Surg Res, 140, 237-42. 

PEO/PIA, PGA, or PCL PEO was central block with PLA, PGA, or PCL extended on both side and terminated with acrylate group. This precursor was photoinitiated by 2,2-dimethoxy-2-piienylacetophenone to fonn gel. Degradation of backbone in pH 7.3 PBS huffei at 37°C witliin 1 day to several months. Control postoperative w ound healing and prevent postoperative adhesion. Sawhney et aL, 1993, 1994 Hubbell el al., 1993... 

West, J.L. and Hubbell, J.A. (1995) Comparison of covalently and physically cross-linked polyethylene glycol-based hydrogels for the prevention of postoperative adhesions in a rat model. Biomalmals, 16(15), 115,3-11.56. 

Sekiba, K., and the Obstetrics and Gynecology Adhesion Prevention Committee (1992) Use of hiterceed (TC7) absorbable adhesion barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. Obstet. Gynecol., 79, 518-22. 

Developments in the u.se of biodegradable polymers in biomedical and surgical applications are reviewed. Applications discussed include tissue engineering, bone fracture fixation devices, resorbable sutures, vascular grafts, temporary barriers for the prevention of postoperative adhesion, artificial skin and systems for controlled drug release. 92 refs. 

Hill-West, J.L., S.M. Chowdhury, A.S. Sawhney, C.P. Pathak, R.C. Dunn, and J.A. Hubbell. 1994. Prevention of postoperative adhesions in the rat by in situ photopolymerization of bioresorbable hydrogel barriers. Obstetrics and Gynecology 83 59-64. 

In situ cross-linkable chitosan-hyaluronic acid based hydrogels for preventing postoperative adhesion has been developed [153]. Hyalmonic acid was oxidized with sodium periodate which cleaves carbon-carbon bonds to create aldehyde groups in D-glucuronic acid units of the molecular chain. The solubility of chitosan in neutral aqueous solution was improved by incorporating carboxymethyl... 

A bioabsorbable film of poly(glycerol sebacate) (PCS) was investigated for prevention of postoperative adhesion in a rat peritoneal adhesion model [159]. This polymer was synthesized by a polycondensation reaction between glycerol and sebacic acid, both of which have FDA approval for use as medical devices. The operated rats were evaluated for adhesions at 3, 5, and 8 weeks postoperatively. Statistically significant reduction (94 %) in adhesion formation rate was observed between the control animals (75 % incidence) and the animals with PGS films (4.8 %). 

Bakkum FA, Trimbos JB, Dalmeyer RAJ, and van Blitterswijk CA. Preventing postoperative intraper-itoneal adhesion formation with Polyactive A degradable copolymer acting as a barrier. J Mater Sci Mater Med, 1995, 6, 41 5. 

Becker, J.M. Dayton, M.T. Fazio, V.M. Beck, D.E. Stryker, S.J. Wexner, S.D. Wolff, B.G. Roberts, P.L. Smith, L.E. Sweeney, S.A. Moore, M. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane a prospective, randomized, double-blind multicenter study. J. Am. Coll. Surg. 1996, 183, 297-306. 

Dipyridamole is indicated as an adjunct to therapy with cou-marin anticoagulant in the prevention of postoperative thromboembolic complications of cardiac valve replacement as an alternative to exercise in thaUium myocardial perfusion imaging for the evaluation of coronary artery disease in patients who are unable to exercise and in long-term therapy for angina pectoris. Dipyridamole inhibits platelet adhesion and is a coronary vasodilator. Inappropriate use of dipyridamole has caused MI, ventricular fibrillation, tachycardia, bronchospasm, and transient cerebral ischania (see also Figures 14 and 92). 

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