Intra-operative locally injected pharmacotherapy as a novel strategy for adhesion prophylaxis

Rajab, Taufiek Konrad; Kraemer, Bernhard; Petri, Nina; Brochhausen, Christoph; Schmitt, Volker H.; Wallwiener, Markus

doi:10.1016/j.ijsu.2012.07.003

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…For SupraSeal, a short-term analysis of the tissue response after 2, 4, and 8 days confirmed the result of this study with respect to an initial florid inflammatory response and low degree of fibrosis. 30 Furthermore, it should be analyzed in future studies what the reasons are, why under some conditions inflammation leads to fibrosis and under others, like shown in our study in the SpraSeal group seems to prevent fibrosis.…”

Section: Discussionmentioning

confidence: 77%

“…In this concern, the combination of an initial inflammation and minor fibrosis in the SupraSeal group is of special interest and the analyzation of the time course of the inflammatory response in view to the formation of fibrosis would be of special interest. For SupraSeal, a short‐term analysis of the tissue response after 2, 4, and 8 days confirmed the result of this study with respect to an initial florid inflammatory response and low degree of fibrosis . Furthermore, it should be analyzed in future studies what the reasons are, why under some conditions inflammation leads to fibrosis and under others, like shown in our study in the SpraSeal group seems to prevent fibrosis.…”

Section: Discussionmentioning

confidence: 99%

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Tissue response to five commercially available peritoneal adhesion barriers—A systematic histological evaluation

Schmitt

Mamilos

Schmitt³

et al. 2017

J Biomed Mater Res

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Separating wounded serosa by physical barriers is the only clinically approved adjunct for postoperative adhesion prevention. Since the optimal adhesion barrier has not been found, it is essential to improve our pathogenic understanding of adhesion formation and to compare the effects of different barrier materials on tissue and cells. Wistar rats underwent standardized peritoneal damage and were treated either with Seprafilm, Adept, Intercoat, Spraygel, SupraSeal or remained untreated as a control. 14 days postoperatively, the lesions were explanted and histomorphologically analyzed using the European ISO score to evaluate material implants. Striking differences between the material groups were present regarding the inflammation, fibrosis, and foreign body reaction. According to the ISO score, Intercoat and Spraygel were considered as nonirritating to tissue. Adept, Seprafilm, and SupraSeal were assessed as mild-irritating materials. Interestingly, the most effective material in adhesion prevention revealed moderate inflammation accompanied by minor fibrosis. The degree of inflammation to barrier materials does not predict the efficacy in the prevention of adhesions. Histopathological investigations are crucial to improve our understanding of the cellular mechanisms during adhesion formation and elucidate the tissue response to material approaches used in adhesion prevention. This will lead to improved antiadhesive strategies and the development of functional barrier biomaterials. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 598-609, 2018.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Tissue response to five commercially available peritoneal adhesion barriers—A systematic histological evaluation

Schmitt

Mamilos

Schmitt³

et al. 2017

J Biomed Mater Res

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“…Considering that the most frequent peritoneal lesion is the surgical incision and synthesis using different suture types, the model of the ischemic peritoneal lesion with foreign body has been the most common 11,12 .…”

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confidence: 99%

Comparative study of polyglactin 910 and simple catgut in the formation of intraperitoneal adhesions

et al. 2018

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Peritoneale Adhäsionsbildung

Hong

Vilz

Kalff

et al. 2015

Chirurg

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Postoperative peritoneal adhesions are common sequelae of abdominal surgery. Acute as well as chronic complications, including bowel obstruction, abdominal pain and infertility can arise from adhesion formation. So far, the only reliable treatment is surgical adhesiolysis, which in turn is accompanied by an increased risk of adhesion recurrence. Despite significant progress in modern perioperative medicine, only limited prophylactic approaches are available and atraumatic surgery is still the most important factor.Current research concepts focus on two major antiadhesion strategies: firstly, the intraoperative placement of mechanical barriers and secondly novel immunomodulation concepts. Clinical data about the use of antiadhesive barriers show a heterogeneous outcome. Promising data have arisen from the immunomodulatory approaches and now require a step-up development from experimental to clinical trial level.The present review gives a short overview about the current research on the pathophysiology and prevention of peritoneal adhesions. The promising data are encouraging and require realization of carefully designed prospective clinical trials.

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Intra-operative locally injected pharmacotherapy as a novel strategy for adhesion prophylaxis

Cited by 6 publications

References 9 publications

Tissue response to five commercially available peritoneal adhesion barriers—A systematic histological evaluation

Tissue response to five commercially available peritoneal adhesion barriers—A systematic histological evaluation

Comparative study of polyglactin 910 and simple catgut in the formation of intraperitoneal adhesions

Peritoneale Adhäsionsbildung

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