Intraperitoneale Adhäsionen

Brochhausen, Christoph

doi:10.1515/biomat.2009.10.1-2.7

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Subsequently, the formation of fibrin bridges to neighbouring tissue occurs and these become organized into a connective tissue, which is the final stage of adhesion formation [20–23]. Clinically, the main strategy in the prevention of postoperative adhesion formation is the use of physical barriers, which separate wounded areas from their environment and so prevent the formation of fibrin bridges and hence peritoneal adhesions [24]. Various barrier materials are available in the form of solid or viscous biomaterials and are currently in clinical use (Table 1) [25, 26].…”

Section: Introductionmentioning

confidence: 99%

Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study

Brochhausen

Schmitt

Mamilos

et al. 2016

J Mater Sci: Mater Med

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In preventing postoperative adhesion formation the optimal barrier material has still not been found. It is therefore imperative to assess the biocompatibility of potential barrier devices. Macrophages play a decisive role in the regulation of wound healing, tissue regeneration and foreign body reaction. Since the number of CD68-positive macrophages represents an important parameter within biomaterial testing, in the present study it was analysed whether a correlation exists between the total number of CD68-positive macrophages and the extent of fibrosis or inflammation in peritoneal adhesion prevention using biomaterials. After standardized peritoneal wounding, Wistar rats were treated with five adhesion barriers or remained untreated as a control. After 14 days, animals were sacrificed and the treated areas were evaluated histomorphologically and immunohistologically. A heterogeneous pattern of macrophage count in relation to fibrosis or inflammation was found. While some groups described a moderate macrophage infiltration without fibrosis, others showed similar numbers of macrophages, but accompanied by moderate fibrosis. Moreover, a minimal number of macrophages was associated with minimal fibrosis. Mild inflammation was seen both with minimal and moderate macrophage infiltration. Altogether, no correlation could be established between the tissue response and the count of CD68-positive macrophages. With a view to macrophage heterogeneity further studies are required to determine the different macrophage subpopulations and clarify the role of these in the tissue responses to barrier materials.

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Section: Introductionmentioning

confidence: 99%

Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study

Brochhausen

Schmitt

Mamilos

et al. 2016

J Mater Sci: Mater Med

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Current Strategies and Future Perspectives for Intraperitoneal Adhesion Prevention

Brochhausen

Schmitt

Planck

et al. 2012

Journal of Gastrointestinal Surgery

132

121

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Mesothelial cells play a crucial physiological role in friction less gliding of the serosa and the maintenance of anantiadhesive surface. The formation of postoperative adhesions results from a cascade of events and is regulated by various cellular and humoral factors. Therefore, optimization or functionalization of barrier materials by developments interacting with this cascade on a structural or pharmacological level could give an innovative input for future strategies in peritoneal adhesion prevention. For this purpose, the proper understanding of the formal pathogenesis of adhesion formation is essential. Based on the physiology of the serosa and the pathophysiology of adhesion formation, the available barriers in current clinical practice as well as new innovations are discussed in the present review.

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Peritoneal Adhesions and their Prevention - Current Trends

et al. 2021

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The development of adhesions after gynecologic surgery is a severe problem with ramifications that go beyond the medical complications patients suffer (which most often include pain, obstruction and infertility), since they also impose a huge financial burden on the health care system and increase the workload of surgeons and all personnel involved in surgical follow-up care. Surgical techniques to avoid adhesion formation have not proven to be sufficient and pharmaceutical approaches for their prevention are even less effective, which means that the use of adhesion prevention devices is essential for achieving decent prophylaxis. This review explores the wide range of adhesion prevention products currently available on the market. Particular emphasis is put on prospective randomized controlled clinical trials that include second-look interventions, as these offer the most solid evidence of efficacy. We focused on adhesion scores, which are the most common way to quantify adhesion formation. This enables a direct comparison of the efficacies of different devices. While the greatest amount of data are available for oxidized regenerated cellulose, the outcomes with this adhesion barrier are mediocre and several studies have shown little efficacy. The best results have been achieved using adhesion barriers based on either modified starch, i.e., 4DryField® PH (PlantTec Medical GmbH, Lüneburg, Germany), or expanded polytetrafluoroethylene, i.e., GoreTex (W.L. Gore & Associates, Inc., Medical Products Division, Flagstaff, AZ), albeit the latter, as a non-resorbable barrier, has a huge disadvantage of having to be surgically removed again. Therefore, 4DryField® PH currently appears to be a promising approach and further studies are recommended.

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Intraperitoneale Adhäsionen

Cited by 3 publications

References 17 publications

Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study

Expression of CD68 positive macrophages in the use of different barrier materials to prevent peritoneal adhesions—an animal study

Current Strategies and Future Perspectives for Intraperitoneal Adhesion Prevention

Peritoneal Adhesions and their Prevention - Current Trends

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