Bioresorbable Hyaluronate-Carboxymethylcellulose Membrane (Seprafilm) in Surgery for Rectal Carcinoma: A Prospective Randomized Clinical Trial

Kusunoki, Masato; Ikeuchi, Hiroki; Yanagi, Hidenori; Noda, Masafumi; Tonouchi, Hitoshi; Mohri, Yasuhiko; Uchida, Keiichi; Inoue, Yasuhiro; Kobayashi, Minàko; Miki, Chikao; Yamamura, Takehira

doi:10.1007/s00595-005-3061-0

Cited by 106 publications

(81 citation statements)

References 10 publications

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“…Products that have had the most documented success in humans are the absorbable gels and films. Although the use of some agents is not without certain caveats (such as the avoidance of wrapping the product around any anastomosis, and ensuring complete hemostasis), randomized control trials have shown statistically significant benefits in their ability to reduce adhesion formation [117,118,119,120,121,122,123,124,125]. As such, the predominance of evidence would suggest that unless there are any contraindications, the surgeon should consider using hyaluronic acid/carboxymethyl membranes.…”

Section: Methods Of Adhesion Reductionmentioning

confidence: 99%

Abdominal Adhesion Prevention: Still a Sticky Subject

et al. 2010

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Background: Adhesion formation remains an almost inevitable consequence of abdominal procedures, potentially resulting in significant morbidity and mortality. There is an ongoing need to evaluate current understanding of adhesion formation and products aimed at prevention. Failure to keep up to date with adhesion treatment may subject clinicians to a greater medico-legal risk. Design: Review of published studies exploring the problem of peritoneal adhesion formation. This encompasses the underlying processes of adhesion formation combined with general approaches to reduce formation. An overview of products trialled to prevent formation in both the animal model and clinical setting describes products of scientific interest and commercial success. Results: Advances in surgical technique, such as laparoscopic surgery, can help minimize the probability of adhesion formation. Currently barrier products, whilst reducing adhesion formation, have not been shown to reduce the risk of readmission with complications related to adhesions. Hybrid products may improve upon this situation. Conclusions: No single approach has been wholly satisfactory in reducing adhesions. Research into the processes driving adhesion formation is providing exciting new targets for therapeutic agents. It would seem plausible that with many promising avenues of research a revolutionary agent to reduce the incidence of adhesional small bowel obstruction may result.

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Section: Methods Of Adhesion Reductionmentioning

confidence: 99%

Abdominal Adhesion Prevention: Still a Sticky Subject

et al. 2010

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“…Adhesions to the omentum were reduced from 79% in the control group to 39% in the Seprafi lm group. Kusunoki et al evaluated the effectiveness of Seprafi lm in preventing abdominal adhesions after radical resection of rectal carcinoma and examined whether Seprafi lm had any adverse effects in patients treated with radiotherapy and chemotherapy [ 46 ] . Sixty-two patients participated and received preoperative radiotherapy followed by a two-stage operation and 5-fl uorouracil (5-FU)-based systemic chemotherapy.…”

Section: Sheetsmentioning

confidence: 99%

Barriers to Prevent Tissue Adhesion

Suzuki

Ikada

2011

Biomaterials for Surgical Operation

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Adhesion often occurs after surgery, especially in abdominal, gynecological, and thoracic surgeries. It can cause serious postsurgical complications such as infertility, chronic pelvic pain, and diffi culties of extensive adhesiolysis in future surgery. Antiadhesive barriers have been developed to provide physical separation between the injured site and the adjacent tissues. Since physical separation is only required during the critical time of wound healing of the damaged area, bioabsorbable polymers have been found to be appropriate. A range of adhesion barriers are commercially available in the forms of solutions, gels, and sheets. Their characteristics and limitations are discussed in this chapter. Recent investigations are also described on newly developed devices that show promising performance such as ease of handling and more effective reduction of adhesion.

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“…In medical use, the effectiveness of native-type hyaluronate has been previously reported in the management of radiation dermatitis [41] [Primavera, 2006], in the prevention of postoperative adhesions in the pelvis [Kusunoki, 2005], and as antioxidant [Campo, 2008], depending on its molecular weight and concentration [Krasinski, 2009].…”

Section: Native-type Hyaluronate Moleculesmentioning

confidence: 99%