Clinical Evaluation of a Haemostatic and Anti-Adhesion Preparation Used to Prevent Post-Surgical Adhesion

Osada, Hiroyuki; Tanaka, Hiroshi; Fujii, T.; Tsunoda, Ikuo; Yoshida, Takao; Satoh, Kanako

doi:10.1177/030006059902700505

Cited by 29 publications

(24 citation statements)

References 2 publications

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“…10 This is unsupported by several studies using fibrinderived materials in animals [11][12][13][14][15][16][17][18][19][20][21][22] and humans. [23][24][25][26] One reason fibrin may be used to reduce rather than enhance adhesions is that once polymerization is complete, an adhesion barrier may form that cannot stick to other surfaces. The hemostatic and sealing properties of fibrin sealants, as well as their widespread availability, make them attractive candidates for use in adhesion prevention.…”

Section: Introductionmentioning

confidence: 99%

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The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat

Wiseman

Lyachovetsky²,

Keidan

et al. 2003

J Biomed Mater Res

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The objective of the research was to determine the effect of the type, dose, and volume of anti-fibrinolytic agents (tranexamic acid, aprotinin) added to fibrin formulations, on adhesion development. Adhesions were induced in 228 male rats by creating apposing parietal and visceral peritoneal defects. Animals were randomized to receive no treatment or a fibrin formulation containing aprotinin or tranexamic acid. Seven days later the incidence of adhesions, and the force and energy required to detach them, were determined. Adhesions developed in 13/13 rats in the control and aprotinin groups. Treatment with fibrin (100 mg/ml tranexamic acid) resulted in adhesions in 4/14 rats (as strips, p < or = 0.0005), 4/10 rats (as spray, p < or = 0.0036), and 12/15 rats (by drip). The reduction of adhesions was dependent on the concentration of tranexamic acid with strip and spray application. Using commercial formulations, tranexamic-acid-containing fibrin (10/15, p = 0.042), but not aprotinin-containing fibrin (13/15), reduced the incidence of side-wall adhesions from 15/15 in controls. Fibrin containing either tranexamic or aprotinin reduced the incidence and severity of adhesions. This effect was greater when tranexamic acid was used and was dependent on the mode of administration, the volume, and to a degree, the concentration of tranexamic acid.

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Section: Introductionmentioning

confidence: 99%

“…Given the clinical use [23][24][25][26] of fibrin preparations for adhesion prevention, the objective therefore was to determine the effect on adhesion development of the type, dose, and volume of antifibrinolytic agents (tranexamic acid, aprotinin) added to fibrin formulations.…”

Section: Introductionmentioning

confidence: 99%

The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat

Wiseman

Lyachovetsky²,

Keidan

et al. 2003

J Biomed Mater Res

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“…In a study of TachoComb ® in patients undergoing gynaecological surgery, all but one of four patients evaluated by second-look laparoscopy (after 3 or 7 months) and all three patients evaluated by caesarean section (after 13 months, 3 years and 4 years) showed no sign of persistent TachoComb ® . 27 In addition, there was no evidence of de novo adhesion formation. 27 Such data demonstrate the natural degradation of the fleece and imply a longterm beneficial effect of TachoComb ® in preventing adhesion-induced infertility, although further long-term follow-up data are required.…”

Section: Discussionmentioning

confidence: 95%

“…27 In addition, there was no evidence of de novo adhesion formation. 27 Such data demonstrate the natural degradation of the fleece and imply a longterm beneficial effect of TachoComb ® in preventing adhesion-induced infertility, although further long-term follow-up data are required.…”

Section: Discussionmentioning

confidence: 95%

Prevention of Gynaecological Adhesions using Haemostatic Fleece in a Rabbit Model

2006

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This pre-clinical study was performed to investigate the ability of the haemostatic fleece TachoComb ® to prevent adhesion formation following uterine surgery. Thirty rabbits were randomized to receive TachoComb ® or no intervention following incision to the right uterine horn. After 14 days, the animals were killed and examined for the presence of adhesion. The lengths of any adhesions were measured and the severity was recorded as a score (0, no adhesion; 1, adhesion easy to lyse; 2, adhesion lysed with traction; 3, adhesion separated by sharp dissection). The incidence of adhesions was 100% in the control group compared with 33% in the TachoComb ® -treated animals. The mean adhesion score was significantly lower (0.7 versus 2.2) and the mean adhesion length category was significantly shorter (0.4 versus 2.0) with TachoComb ® than in the control group. This study indicates that TachoComb ® is a well-tolerated and effective means of preventing adhesion following gynaecological surgery.

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“…TachoComb ® continues to be applied in endoscopic (23), vascular, thyroid, lung, hepatic, urological and ENT surgery, gynaecology and obstetrics (1,2,6,15), as well as in macroscopic and histological experimental studies (3,11,19,20) and in neurosurgery, where it serves as a dural substitute (14,17).…”

Section: Introductionmentioning

confidence: 99%

Watertightness and Effectiveness of a Fibrinogen-Based Collagen Fleece (TachoComb®) in Neurosurgery

et al. 2003

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Background: Meningitis or cerebrospinal fluid rhinorrhoea can occur years or even decades after trauma or operation and can be the first indication of a previously unidentified dural lesion. Preventing cerebrospinal fluid (CSF) leakage with a fibrinogen-based collagen fleece (TachoComb ® ) was the interest of our clinical study. Methods: In the present study, we examined the watertightness and effectiveness of TachoComb ® following supratentorial/infratentorial as well as skull-base operations. The dura was closed primarily by sutures and covered with a fibrinogen-based collagen fleece to prevent CSF leakage. Results: Twelve patients developed a subcutaneous CSF collection requiring no further treatment, seven patients were managed by lumbar CSF drainages, and three patients had to be reoperated. Conclusions: Based on these results, we proved the watertightness and effectiveness of this fibrinogen-based collagen fleece. (Eur. Surg. 2003; 35:278-281) Wasserdichtheit und klinische Verwendung von TachoComb ® in der Neurochirurgie Zusammenfassung: Grundlagen: Eine Meningitis oder eine Liquorfistel kann Jahre bis Jahrzehnte nach einem Trauma oder einer neurochirurgischen Operation erstmalig auftreten. Als Prophylaxe gegen eine Liquorfistel haben wir ein resorbierbares Kollagenvlies, das mit Bestandteilen eines Fibrinklebers beschichtet ist (TachoComb ® ) klinisch getestet. Methodik: In unserer vorliegenden Studie haben wir die Wasserdichtheit von TachoComb ® in 421 Fällen getestet. Die primär vernähte Dura mater wurde mit einem beschichteten Kollagenvlies bedeckt, ebenso die Schädelbasis nach Schädelba-sisoperationen. Ergebnisse: 12 Patienten entwickelten ein subcutanes Liquorkissen, welches keiner weiteren Therapie bedurfte. In 7 Fällen wurden die Patienten mit einer Lumbaldrainage behandelt und in 3 Fällen mußte reoperiert werden um den Defekt zu decken. Schlussfolgerungen: Basierend auf diesen Ergebnissen kön-nen wir die Verwendung von TachoComb ® zum Erreichen eines wasserdichten Duraverschlusses empfehlen.

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Clinical Evaluation of a Haemostatic and Anti-Adhesion Preparation Used to Prevent Post-Surgical Adhesion

Cited by 29 publications

References 2 publications

The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat

The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat

Prevention of Gynaecological Adhesions using Haemostatic Fleece in a Rabbit Model

Watertightness and Effectiveness of a Fibrinogen-Based Collagen Fleece (TachoComb®) in Neurosurgery

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