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Adhesion

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William D Schlaff – 1st expert on this subject based on the ideXlab platform

  • expanded polytetrafluoroethylene gore tex surgical membrane is superior to oxidized regenerated cellulose interceed tc7 in preventing Adhesions
    Fertility and Sterility, 1995
    Co-Authors: A F Haney, John S Hesla, Bradley S Hurst, Michael L Kettel, Anna A Murphy, John A Rock, Guillermo Rowe, William D Schlaff

    Abstract:

    Objective To compare the impact of expanded polytetrafluoroethylene (PTFE; Gore-Tex Surgical Membrane; W. L. Gore & Associates, Inc., Flagstaff, AZ) and oxidized regenerated cellulose (Interceed TC7, Johnson & Johnson Medical, Inc., Arlington, TX) on the development of postsurgical Adhesions. Design A multicenter, nonblinded, randomized clinical trial. Setting University medical centers. Interventions Each barrier was allocated randomly to the left or right sidewall of every patient. Patients Thirty-two women with bilateral pelvic sidewall Adhesions undergoing reconstructive surgery and second-look laparoscopy. Main Outcome Measures Adhesion score (on a 0- to 11-point scale), the area of Adhesion (cm 2 ), and the likelihood of no Adhesions. Results The use of both barriers was associated with a lower Adhesion score and area of Adhesion postoperatively. However, those sidewalls covered with PTFE had a significantly lower Adhesion score (0.97±0.30 versus 4.76±0.61 points, mean±SEM) and area of Adhesion (0.95±0.35 versus 3.25±0.62cm 2 ). Overall, more sidewalls covered with PTFE had no Adhesions (21 versus 7) and, when Adhesions were present on the contralateral sidewall, the number of sidewalls covered with PTFE without Adhesions was greater than those covered with oxidized regenerated cellulose (16 versus 2). Conclusion Expanded polytetrafluoroethylene was associated with fewer postsurgical Adhesions to the pelvic sidewall than oxidized regenerated cellulose.

  • Expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane*) is superior to oxidized regenerated cellulose (Interceed TC7 †) in preventing Adhesions‡§
    Fertility and Sterility, 1995
    Co-Authors: A F Haney, John S Hesla, Bradley S Hurst, Anna A Murphy, John A Rock, Guillermo Rowe, L. Michael Kettel, William D Schlaff

    Abstract:

    Objective To compare the impact of expanded polytetrafluoroethylene (PTFE; Gore-Tex Surgical Membrane; W. L. Gore & Associates, Inc., Flagstaff, AZ) and oxidized regenerated cellulose (Interceed TC7, Johnson & Johnson Medical, Inc., Arlington, TX) on the development of postsurgical Adhesions. Design A multicenter, nonblinded, randomized clinical trial. Setting University medical centers. Interventions Each barrier was allocated randomly to the left or right sidewall of every patient. Patients Thirty-two women with bilateral pelvic sidewall Adhesions undergoing reconstructive surgery and second-look laparoscopy. Main Outcome Measures Adhesion score (on a 0- to 11-point scale), the area of Adhesion (cm 2 ), and the likelihood of no Adhesions. Results The use of both barriers was associated with a lower Adhesion score and area of Adhesion postoperatively. However, those sidewalls covered with PTFE had a significantly lower Adhesion score (0.97±0.30 versus 4.76±0.61 points, mean±SEM) and area of Adhesion (0.95±0.35 versus 3.25±0.62cm 2 ). Overall, more sidewalls covered with PTFE had no Adhesions (21 versus 7) and, when Adhesions were present on the contralateral sidewall, the number of sidewalls covered with PTFE without Adhesions was greater than those covered with oxidized regenerated cellulose (16 versus 2). Conclusion Expanded polytetrafluoroethylene was associated with fewer postsurgical Adhesions to the pelvic sidewall than oxidized regenerated cellulose.

Geoffrey Trew – 2nd expert on this subject based on the ideXlab platform

  • Postoperative abdominal Adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce Adhesions
    Gynecological Surgery, 2007
    Co-Authors: Rudy Leon Dewilde, Geoffrey Trew

    Abstract:

    This consensus position represents the collective views of 35 gynaecologists with a recognised interest in Adhesions. The first part of the position was presented in the previous issue of Gynecological Surgery and reviewed the published literature on the extent of the problem of Adhesions. In this part, the opportunities to reduce their incidence are considered. Collective proposals on the actions that European gynaecologists should take to avoid causing Adhesions are provided. Importantly, in this part, the need to now inform patients of the risks associated with Adhesion-related complications during the consent process is discussed. With evidence increasing to support the efficacy of Adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce Adhesions and fulfil their duty of care to patients.

  • Postoperative abdominal Adhesions and their prevention in gynaecological surgery. Expert consensus position
    Gynecological Surgery, 2007
    Co-Authors: Rudy Leon Dewilde, Geoffrey Trew

    Abstract:

    Adhesions are the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. While Adhesions may cause few or no detrimental effects to patients, in a considerable proportion of cases there are major short- and long-term consequences, including small-bowel obstruction, infertility and chronic pelvic pain. Adhesions complicate future surgery with important associated morbidity and expense—and a considerable risk of mortality. Despite advances in surgical techniques in recent years, the burden of Adhesion-related complications has not changed. Adhesions should now be considered the most common complication of abdominopelvic surgery. Adhesiolysis remains the main treatment, despite the fact that Adhesions reform in most patients. Developments in Adhesion-reduction strategies and new agents now offer a realistic possibility of reducing the risk of Adhesions forming and can improve the outcomes for patients and the associated onward burden. This consensus position represents the collective views of 35 gynaecologists with a recognised interest in Adhesions. The position is presented in two parts. The first part reviews the published literature on the extent of the problem of Adhesions, and the second part considers the opportunities to reduce their incidence. It also provides collective proposals on the actions that European gynaecologists should take to avoid causing Adhesions. Importantly it also advises that it is now time to inform patients of the risks associated with Adhesion-related complications during the consent process. With increasing evidence to support the efficacy of Adhesion-reduction agents to complement good surgical practice, all surgeons should act now to reduce Adhesions and fulfil their duty of care to patients.

  • Postoperative Adhesions and their prevention
    Reviews in Gynaecological and Perinatal Practice, 2006
    Co-Authors: Geoffrey Trew

    Abstract:

    Abstract This review provides an overview of the background evidence that has led to current recommendations on Adhesion reduction management. The extent, epidemiology and financial implications of abdominopelvic Adhesions and their related complications is discussed. Strategies for the prevention of Adhesions are presented including a review of current anti-Adhesion agents. Finally, the potential impact of progressing routine anti-Adhesion strategies and indeed the potential impact of not doing this are considered.

A F Haney – 3rd expert on this subject based on the ideXlab platform

  • expanded polytetrafluoroethylene gore tex surgical membrane is superior to oxidized regenerated cellulose interceed tc7 in preventing Adhesions
    Fertility and Sterility, 1995
    Co-Authors: A F Haney, John S Hesla, Bradley S Hurst, Michael L Kettel, Anna A Murphy, John A Rock, Guillermo Rowe, William D Schlaff

    Abstract:

    Objective To compare the impact of expanded polytetrafluoroethylene (PTFE; Gore-Tex Surgical Membrane; W. L. Gore & Associates, Inc., Flagstaff, AZ) and oxidized regenerated cellulose (Interceed TC7, Johnson & Johnson Medical, Inc., Arlington, TX) on the development of postsurgical Adhesions. Design A multicenter, nonblinded, randomized clinical trial. Setting University medical centers. Interventions Each barrier was allocated randomly to the left or right sidewall of every patient. Patients Thirty-two women with bilateral pelvic sidewall Adhesions undergoing reconstructive surgery and second-look laparoscopy. Main Outcome Measures Adhesion score (on a 0- to 11-point scale), the area of Adhesion (cm 2 ), and the likelihood of no Adhesions. Results The use of both barriers was associated with a lower Adhesion score and area of Adhesion postoperatively. However, those sidewalls covered with PTFE had a significantly lower Adhesion score (0.97±0.30 versus 4.76±0.61 points, mean±SEM) and area of Adhesion (0.95±0.35 versus 3.25±0.62cm 2 ). Overall, more sidewalls covered with PTFE had no Adhesions (21 versus 7) and, when Adhesions were present on the contralateral sidewall, the number of sidewalls covered with PTFE without Adhesions was greater than those covered with oxidized regenerated cellulose (16 versus 2). Conclusion Expanded polytetrafluoroethylene was associated with fewer postsurgical Adhesions to the pelvic sidewall than oxidized regenerated cellulose.

  • Expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane*) is superior to oxidized regenerated cellulose (Interceed TC7 †) in preventing Adhesions‡§
    Fertility and Sterility, 1995
    Co-Authors: A F Haney, John S Hesla, Bradley S Hurst, Anna A Murphy, John A Rock, Guillermo Rowe, L. Michael Kettel, William D Schlaff

    Abstract:

    Objective To compare the impact of expanded polytetrafluoroethylene (PTFE; Gore-Tex Surgical Membrane; W. L. Gore & Associates, Inc., Flagstaff, AZ) and oxidized regenerated cellulose (Interceed TC7, Johnson & Johnson Medical, Inc., Arlington, TX) on the development of postsurgical Adhesions. Design A multicenter, nonblinded, randomized clinical trial. Setting University medical centers. Interventions Each barrier was allocated randomly to the left or right sidewall of every patient. Patients Thirty-two women with bilateral pelvic sidewall Adhesions undergoing reconstructive surgery and second-look laparoscopy. Main Outcome Measures Adhesion score (on a 0- to 11-point scale), the area of Adhesion (cm 2 ), and the likelihood of no Adhesions. Results The use of both barriers was associated with a lower Adhesion score and area of Adhesion postoperatively. However, those sidewalls covered with PTFE had a significantly lower Adhesion score (0.97±0.30 versus 4.76±0.61 points, mean±SEM) and area of Adhesion (0.95±0.35 versus 3.25±0.62cm 2 ). Overall, more sidewalls covered with PTFE had no Adhesions (21 versus 7) and, when Adhesions were present on the contralateral sidewall, the number of sidewalls covered with PTFE without Adhesions was greater than those covered with oxidized regenerated cellulose (16 versus 2). Conclusion Expanded polytetrafluoroethylene was associated with fewer postsurgical Adhesions to the pelvic sidewall than oxidized regenerated cellulose.