Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis
Background. Adhesions occur after up to 97% of abdominal interventions causing chronic pain, infertility, and intestinal obstruction. Various concepts to prevent adhesions have been presented but mostly either have low efficacy or are not applicable in resective intestinal surgery or incomplete hemo...
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Wiley
2018-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2018/9628742 |
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| author | Gerhard Blumhardt Matthias Haas Stefanie Polte |
| author_facet | Gerhard Blumhardt Matthias Haas Stefanie Polte |
| author_sort | Gerhard Blumhardt |
| collection | DOAJ |
| description | Background. Adhesions occur after up to 97% of abdominal interventions causing chronic pain, infertility, and intestinal obstruction. Various concepts to prevent adhesions have been presented but mostly either have low efficacy or are not applicable in resective intestinal surgery or incomplete hemostasis. In this retrospective one-center clinical trial, the course of patients with extensive abdominal adhesiolysis and application of a recent starch-based formulation, 4DryField PH (4DF), is analyzed. Case Report. Five female patients (age 65–83 years) underwent extensive open adhesiolysis with application of 4DF gel for adhesion prevention, premixed extracorporeally with saline or Ringer’s solution (60–70 mL per 5 g 4DF) for homogeneous gel distribution on intestinal loops and in the peritoneal cavity. In addition, dry 4DF powder was dispersed on the greater omentum and subsequently transformed into a gel by dripping with saline or Ringer’s solution directly before abdominal closure. Patients were followed up for more than two years, except for one patient who died after nine months due to metastases. One patient with complex situation due to Gore-Tex mesh in the lower abdomen showed no adhesions at scheduled second-look operation but after six months had relaparotomy for adhesiolysis. All other patients have remained free of adhesions or adhesion-related symptoms during follow-up. Conclusion. Considering the extent and complexity of adhesions, treatment with 4DF gel for adhesion prevention after open adhesiolysis appears promising. Prospective randomized trials should further elaborate on this clinical concept. |
| format | Article |
| id | doaj-art-1fc93856dd2e4e9ebda3dedba8858c7c |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-1fc93856dd2e4e9ebda3dedba8858c7c2025-02-03T05:50:46ZengWileyCase Reports in Surgery2090-69002090-69192018-01-01201810.1155/2018/96287429628742Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral AdhesiolysisGerhard Blumhardt0Matthias Haas1Stefanie Polte2Department of General and Visceral Surgery, Evangelisches Krankenhaus Unna, Holbeinstr. 10, 59423 Unna, GermanyDepartment of General and Visceral Surgery, Evangelisches Krankenhaus Unna, Holbeinstr. 10, 59423 Unna, GermanyDepartment of General and Visceral Surgery, Evangelisches Krankenhaus Unna, Holbeinstr. 10, 59423 Unna, GermanyBackground. Adhesions occur after up to 97% of abdominal interventions causing chronic pain, infertility, and intestinal obstruction. Various concepts to prevent adhesions have been presented but mostly either have low efficacy or are not applicable in resective intestinal surgery or incomplete hemostasis. In this retrospective one-center clinical trial, the course of patients with extensive abdominal adhesiolysis and application of a recent starch-based formulation, 4DryField PH (4DF), is analyzed. Case Report. Five female patients (age 65–83 years) underwent extensive open adhesiolysis with application of 4DF gel for adhesion prevention, premixed extracorporeally with saline or Ringer’s solution (60–70 mL per 5 g 4DF) for homogeneous gel distribution on intestinal loops and in the peritoneal cavity. In addition, dry 4DF powder was dispersed on the greater omentum and subsequently transformed into a gel by dripping with saline or Ringer’s solution directly before abdominal closure. Patients were followed up for more than two years, except for one patient who died after nine months due to metastases. One patient with complex situation due to Gore-Tex mesh in the lower abdomen showed no adhesions at scheduled second-look operation but after six months had relaparotomy for adhesiolysis. All other patients have remained free of adhesions or adhesion-related symptoms during follow-up. Conclusion. Considering the extent and complexity of adhesions, treatment with 4DF gel for adhesion prevention after open adhesiolysis appears promising. Prospective randomized trials should further elaborate on this clinical concept.http://dx.doi.org/10.1155/2018/9628742 |
| spellingShingle | Gerhard Blumhardt Matthias Haas Stefanie Polte Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis Case Reports in Surgery |
| title | Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis |
| title_full | Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis |
| title_fullStr | Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis |
| title_full_unstemmed | Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis |
| title_short | Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis |
| title_sort | effect of 4dryfield r ph a novel adhesion barrier on recurrence of intestinal adhesions after extensive visceral adhesiolysis |
| url | http://dx.doi.org/10.1155/2018/9628742 |
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