The new adhesion prophylaxis membrane A‐part®—From in vitro testing to first in vivo results

Abstract

The properties of the A-part membrane suggest that it may be useful as an antiadhesive in surgery. A-part is effective in in vivo testing as determined in a rabbit sidewall model.

The Influence of Enzymes on Adhesive Processes in the Abdominal Cavity

“…Pathologic angiogenesis occurs when the eff ect of stimulatory molecules outweighs the eff ect of inhibitory molecules. Intensive study has shown that the angiogenic process involves more than the simple proliferation of endothelial cells; it requires that endothelial cells to divide and invade the basement membrane, migrate, and undergo diff erentiation and capillary-tube formation [7,11] . This process is driven by angiogenic molecules as well as other factors, such as degradative enzymes, which mediate the above processes.…”

Effects of New Anti-Adhesion Polyvinyl Alcohol Gel on Healing of Colon Anastomoses in Rats

“…To improve quality of adherence of the barrier to the viscera, CMC was added to PVA gel. Jaenigen et al [14] showed in a rabbit sidewall model that this PVA-CMC gel diminishes adhesions compared with untreated controls and animals given 4% icodextrin. Lang et al [15] found similar results in their rabbit sidewall model; significantly fewer adhesions were present in rabbits treated with PVA-CMC gel than in those given 4% icodextrin and in controls.…”

“…Numerous products have been tested to minimize the formation of adhesions, based on barriers that separate the injured surfaces long enough to allow repair without adhesions. A new adhesion barrier consisting of polyvinyl alcohol (PVA) and carboxymethylcellulose (CMC) gel (A-Part Gel Ò ; Aesculap AG, B. Braun, Tuttlingen, Germany) has shown promising results in in vitro as well as in vivo studies [14][15][16]. However, in past years, several anti-adhesive agents have not entered widespread clinical use because of concerns about their interference with anastomotic site healing [17,18].…”

A-Part Gel, an adhesion prophylaxis for abdominal surgery: a randomized controlled phase I–II safety study [NCT00646412]

“…A variety of experimental studies in different animal models have been conducted which showed that A-Part Gel ® is efficacious in the reduction of post-surgical adhesions in vivo [ 11 – 16 ]. Therefore, the aim of this study was clearly the evaluation of the safety and secondly an estimation of the efficacy of this hydrogel in the peritoneal adhesions prevention after primary elective laparotomy compared to an untreated control group in humans.…”