Prevention of postoperative pericardial adhesions with hydrophilic polymer solutions

Duncan, David; Yaacobi, Yoseph; Goldberg, Eugene P.; Mines, Melissa T.; O’Brien, David; Congdon, F.; Carmichael, Michael J.

doi:10.1016/0022-4804(88)90019-4

Cited by 52 publications

(47 citation statements)

References 16 publications

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“…Several natural barriers such as peritoneum, omentum, and amnion [13,14], and synthetic physical barriers such as silicone, polytetrafluoroethylene, cellulose, polyvinyl alcohol, and polyester derivatives also have been tried. Some of them were tried in the retrosternal space [3][4][5][15][16][17][18]. The basic mechanism of physical barriers for preventing adhesion is separating the injured tissue surface from the adjacent tissues [19].…”

Section: Discussionmentioning

confidence: 99%

“…The basic mechanism of physical barriers for preventing adhesion is separating the injured tissue surface from the adjacent tissues [19]. Physical barrier methods have been tried for decades to prevent postoperative tissue adhesion [3][4][5][15][16][17][18]20]. Among them, there are film barriers, solution barriers, and recently developed solgel transition barriers.…”

Section: Discussionmentioning

confidence: 99%

“…Because of this problem, a number of attempts have been made to develop suitable materials to prevent the formation of postsurgical adhesion [3][4][5]. However, an ideal method to prevent postoperative pericardial adhesion formation has not yet been found [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Barrier Materials on Reduction of Pericardial Adhesion Formation in Rabbits: A Comparative Study of a Hyaluronan-Based Solution and a Temperature Sensitive Poloxamer Solution/Gel Material

Hong

Choe

Kwon

et al. 2011

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Effects of Barrier Materials on Reduction of Pericardial Adhesion Formation in Rabbits: A Comparative Study of a Hyaluronan-Based Solution and a Temperature Sensitive Poloxamer Solution/Gel Material

Hong

Choe

Kwon

et al. 2011

Journal of Surgical Research

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“…1,15 Between 1980 and 1999, 22.8% of all valve surgery registered at the Heart Institute of São Paulo University were reoperations. An estimate of 50,000 re-entries are performed in the USA 16 every year.…”

Section: Discussionmentioning

confidence: 99%

“…8,17,18 A 50% mortality rate has been described, when a major haemorrhage or coronary bypass graft lesions occurs. 2,15,19 Furthermore, pericardial adhesions can reduce the right ventricle function 1,20 and the patency of vascular grafts. 21,22 Currently, although some surgeons use innovative methods to deal with re-entry, 23 these procedures are, so far, cumbersome and time consuming.…”

Section: Discussionmentioning

confidence: 99%

New quantitative variables to measure postoperative pericardial adhesions: useful tools in experimental research

Lopes¹,

Dallan²,

Moreira³

et al. 2009

Acta Cir. Bras.

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PURPOSE: To improve the measurement system, during a research for the prevention of adhesions, we explored the feasibility of introducing three continuous numeric variables to quantify the intensity of pericardial adhesions. METHODS: To validate these three new numeric variables - time spent to dissect the adhesions (Δt), the amount of sharp dissection (ShpD) and the adhesion's collagen area (ACA) - as useful tools in measuring the severity of pericardial adhesions, data from a randomized study on adhesion prevention enrolling twenty-four swine, were analysed. A statistical Spearman's test and regressions models were applied to verify the correlation and the relationship between the results of a standard severity score (SS) and Δt, between SS and ShpD used in adhesiolysis and, also, between SS and ACA. RESULTS: There was a statistically significant correlation between SS and Δt, between SS and ShpD, as well as between SS and ACA, all measured by the Spearman's test (r=0.897, r=0.932, r=0.66; p<0.01, respectively). Through a non-linear regression, an exponential relation of SS with ShpD (R²=0.915) and SS with Δt (R²= 0.917) was found. CONCLUSION: The time spent to dissect the adhesions (Δt) and the amount of sharp dissection (ShpD) are new powerful measurement tools in evaluating outcomes of the methods used to prevent pericardial adhesions.

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Novel adhesion prevention membrane based on a bioresorbable copoly(ester-ether) comprised of poly-L-lactide and Pluronic�:In vitro andin vivo evaluations

Yamaoka

Takahashi

Fujisato

et al. 2000

J. Biomed. Mater. Res.

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Block copolymers consisting of poly(L-lactide) (PLLA) and poly(oxyethylene-co-oxypropylene), with various compositions, were synthesized and characterized in vitro and in vivo for their application as postoperative adhesion prevention membranes. It was found that the flexibility and degradability of the cast films of the block copolymers grew with increasing Pluronic F68 [PN; poly(oxyethylene-co-oxypropylene] composition. The receding contact angle of the copolymer films against water became lower than that of the PLLA film, because the surface was predominantly covered with more hydrophilic PN segments in a wet state. This surface property significantly affects the cell attachment property of the copolymer films, and the fibroblasts cultured on the films exhibit a spheroid-like morphology. The copolymer films subcutaneously implanted in the back of rats induced milder tissue responses compared with PLLA homopolymers, because of the increased surface hydrophilicity in the former. In vivo evaluation using a uterus horn model in rats revealed that the performance of these copolymer films as an adhesion-prevention membrane is comparable to that of a conventionally utilized membrane of oxidized regenerated cellulose. These results indicate that the copolymer films are biocompatible materials with controllable mechanical properties and biodegradability as adhesion-prevention membranes.

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Prevention of postoperative pericardial adhesions with hydrophilic polymer solutions

Cited by 52 publications

References 16 publications

The Effects of Barrier Materials on Reduction of Pericardial Adhesion Formation in Rabbits: A Comparative Study of a Hyaluronan-Based Solution and a Temperature Sensitive Poloxamer Solution/Gel Material

The Effects of Barrier Materials on Reduction of Pericardial Adhesion Formation in Rabbits: A Comparative Study of a Hyaluronan-Based Solution and a Temperature Sensitive Poloxamer Solution/Gel Material

New quantitative variables to measure postoperative pericardial adhesions: useful tools in experimental research

Novel adhesion prevention membrane based on a bioresorbable copoly(ester-ether) comprised of poly-L-lactide and Pluronic�:In vitro andin vivo evaluations

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