• Title/Summary/Keyword: Adhesions

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The Effect of Alloderm on Prevention of Adhesions following Tenorrhaphy in the Rabbits (알로덤이 건 봉합술 후 발생되는 유착 방지에 미치는 효과)

  • Choi, Chang Yong;Song, Jin Woo;Kim, Jun Hyuk;Choi, Hwan Jun;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.765-770
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    • 2007
  • Purpose: Peritendinous adhesion is one of the most notorious complication after the flexor tendon injury. In this study, $Alloderm^{(R)}$(LifeCell Corp., Branchburg, N.J.), which is the decellularized human dermal analogue with its intact native basement membrane components, was used for the prevention of peritendinous adhesions following flexor tendon repair. Methods: Thirty New Zealand white male rabbits were divided equally into 3 groups. In all groups, the flexor digitorum profundus of the third finger of the right back foot was cut totally and repaired by modified Kessler suture technique. Following tendon repair, $Alloderm^{(R)}$ was wrapt around the repaired tendon in the first group and sodium hyaluronate gel was sprayed to the operation field in the second group. In the control group, no external material was applied. The right back foot were immobilized for 6 weeks to optimize the formation of adhesion ingrowth. After death, the third finger that repaired tendons and sheaths was removed en bloc. We checked range of motion. and studied histologically for all groups. Results: The experimental groups had better range of motion than the control group. We checked that the range of motion was 73.5 degrees in $Alloderm^{(R)}$ group, 55.9 degrees in the hyaluronic acid group, and 38.3 degrees in the control group. in the histological study, the experimental group had less adhesions compared with the control group. Conclusion: This study concludes that $Alloderm^{(R)}$ can decrease peritendinous adhesions following flexor tendon repairs in rabbits. We think the method could be used in clinical cases.

Prevention of Postsurgical Adhesions with a Mixed Gel of Sodium Carboxymethyl Cellulose and Gellan Gum in the Rat (흰쥐에서의 카르복시메칠셀룰로오스나트륨과 겔란검 혼합겔의 유착방지 효과)

  • Kwon, Yun-Hwan;Lee, Si-Beum;Lee, Jong-Goen;Park, Yong-Deuk;Park, Jeong-Sook;Hwang, Sung-Joo
    • Journal of Pharmaceutical Investigation
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    • v.34 no.6
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    • pp.477-482
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    • 2004
  • The aim of the present study was to investigate the efficacy of a mixed gel formulation composed of sodium carboxymethyl cellulose and gellan gum (Na-CMC gel) for the prevention of adhesions after laminectomy. The anti-adhesive effect of the Na-CMC gel was tested in a controlled randomized study using an animal model of lumbar laminectomy. The animals (60 female Sprague-Dawley rats) were randomly allocated into two treatment groups to receive the Na-CMC gel on the injured area or no gel (control). The incidence of adhesions and their grade were blindly evaluated at 4, 8 and 12 weeks after surgery. The amount of scar tissue and tenacity were grossly reduced by the Na-CMC gel at postoperative 4, 8, and 12 weeks. The mean adhesion scores were 0.75, 1.25, and 1.38 at 4, 8, and 12 weeks in the gel-treated group, respectively. No significant inflammatory reaction was observed and the healing of wound was not affected by the Na-CMC gel. The Na-CMC gel reduced the amount of scar formation and tenacity in rat laminectomy model without affecting the healing of operation wound and other complications. Therefore, the Na-CMC gel may be the potential to prevent postsurgical adhesions in clinical state.

Efficacies of Sodium Carboxymethylcellulose, Oxidized Regenerated Cellulose and Vitamin E in Prevention Against Postoperative Adhesion Formation in Dogs (개에서 복강수술 후 유착방지에 대한 Sodium carboxymethylcellulose, Oxidized regenerated cellulose, Vitamin E의 효과)

  • Kim, Jung-Eun;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.698-703
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    • 2010
  • This study was performed to compare the efficacy of the sodium carboxymethylcellulose (SCMC), oxidized regenerated cellulose (ORC), and their combination with vitamin E for the prevention of postoperative adhesions in the dog. Twenty five dogs were randomly divided into five groups ; non-treated group (Control Group), SCMC-treated group (SCMC Group), ORC-treated group (ORC Group), vitamin E and SCMC-treated group (SCMC + E Group), and vitamin E and ORC-treated group (ORC + E group). After laparotomy, 5 abrasions were made to induce intraperitoneal adhesions on the surface of the ileal serosa. The adhesions were occurred in serosa to mesentary (37.6%), serosa to serosa (24%), serosa to omentum (8.8%) and serosa to parietal peritoneum (3.2%). The incidences of adhesions were 92%, 84%, 64%, 56% and 68% in Control, SCMC, ORC, SCMC+E and ORC + E Group, respectively. The adhesion scores in SCMC+E Group were significantly lower than those in the other groups (p < 0.01). In conclusion, this study showed that oral supplements of vitamin E and intraperitoneal administration of 2% SCMC solution were effective on reducing intraperitoneal adhesions in the dog.

Preparation and Characterization of biodegradable nonwoven type mulching using waste cotton (폐면을 이용한 생분해 부직포 멀칭의 제조 및 특성 분석)

  • Yeum, Jeong Hyun;Cho, Jin Won;Lee, Hak Kwon;Bae, Do Gyu;Choi, Jin Hyun
    • Current Research on Agriculture and Life Sciences
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    • v.27
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    • pp.35-41
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    • 2009
  • In this study, waste natural fibers and natural adhesions were used to prepare an environmental biodegradable nonwoven type mulching material. Especially, the nonwoven mulching with higher content of cotton shows a improved biodegradation. Also, the physical properties of nonwoven mulching with different ratios of cotton/rayon were studied. It was found that the degree of biodegradation was controlled by the type of nonwoven materials and adhesions.

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A Novel Balloon-Inflatable Catheter for Percutaneous Epidural Adhesiolysis and Decompression

  • Choi, Seong Soo;Joo, Eun Young;Hwang, Beom Sang;Lee, Jong Hyuk;Lee, Gunn;Suh, Jeong Hun;Leem, Jeong Gill;Shin, Jin Woo
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.178-185
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    • 2014
  • Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.

A Comparison of Three Suture Techniques on Adhesion in End-to-end Intestinal Anastomosis of Dogs (개에서 세가지 단단장문합 봉합법에 따른 유착비교)

  • Kim, Je-Sun;Jeong, Soon-Wuk;Kim, Joon-Young;Jeong, Man-Bok;Han, Hyun-Jung
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.12-21
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    • 2003
  • In this study, we evaluated effects of three anastomotic techniques of small intestine on adhesions in the dog. Twenty six healthy mixed dogs were randomly assigned to three groups. Group I(n = 8) was sutured with a simple continuous suture, group II(n = 7) was sutured with a simple interrupted approximating suture and group III(n = 11) was sutured with a single layer continuous Connell suture. On completion of any intestinal anastomosis, a pedicle of greater omentum was wrapped around the suture line in all experimental dogs. One percent sodium carboxymeth-ylcellulose (5ml/kg) was administrated into the abdomen by feeding tube prior to closing the last part of peritoneum in all dogs. Postoperative adhesions were evaluated at 14th day after operation. The adhesions consisted primarily in two dogs in group I, three dogs in group II and group III. There were adhesions between intestinal serosal surfaces in eight dogs in all groups, but there were no intestinal serosa-visceral peritoneum adhesion and intestinal serosa-mesentery adhesion. Mean adhesion scores were less than score 2 in all groups. Between anastomotic site and omental graft, there were 13.13$\pm$4.97 mm (mean$\pm$S.D.) adhesion formation in group I and 17.29$\pm$4.68 mm in group II and 14.64$\pm$3.80mm in group III. A simple continuous suture resulted in the least adhesion formation and a simple interrupted approximating suture resulted in the greatest adhesion formation among the groups. However, there were no significant differences among three suture techniques in the severity of adhesions. Intestinal intussusception only encountered in one dog during the 14 days, the dog operated and survived. Daily monitoring of temperature, activity, appetite, defecation and micturition were done. All of those vital signs were within normal values and there were no obvious differences among the groups. In conclusion, even though there were no significant differences among three groups, a simple continous suture pattern is recommended to prevent adhesions when operating intestinal anastomosis in dogs.

The Effects of Poloxamer/Sodium Alginate Mixture Barriers on Prevention of Post-Operative Peritoneal Adhesion in Dogs (개에서 Poloxamer / Sodium Alginate 혼합물의 복강 유착 방지 효과)

  • Kim, Ji-Hun;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.324-330
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    • 2009
  • This study was performed to determine the effectiveness of poloxamer/sodium alginate mixture(PX/SA) barriers on prevention of post-operative peritoneal adhesion in dogs. Fifteen mongrel dogs were divided into three experimental groups: non-treated group, 2% Sodium Carboxymethylcellulose (SCMC) treated group and PX/SA treated group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogeneous petechial hemorrhagic surface over a 1 ${\times}$ 1 cm area. Solution of SCMC was allowed to spread across the intraperitoneal organs through a catheter using a syringe. PX/SA was simply coated over the abraded tissues. On day before and day 1, 4, 7, and 14 after operation, venous blood specimens were collected for measurement of RBC, total WBC and fibrinogen. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The RBC, total WBC and fibrinogen values of three groups showed no statistical significances. The mean tensile strength(gram force, gf) of formed adhesions on day 21 after surgery was 173.05${\pm}$113.48 in the non-treated group, 111.42 ${\pm}$ 38.25 in the SCMC group, and 69.00 ${\pm}$ 45.07 in the PX/SA group. The tensile strength values for adhesion seperation in PX/SA group was lower than those in SCMC group(p < 0.05) and significantly lower than those in the non-treated group(p < 0.05). Our data suggested that PX/SA should be effective on reducing peritoneal adhesion formation in dogs compared with SCMC. PX/SA may be applicable to preventing post-operative intraperitoneal adhesion in dogs.

Effect of carboxymethyl chitosan on postoperative intraperitoneal adhesion formation in the rat (Rat에서 carboxymethyl chitosan의 복강수술후 유착형성에 미치는 효과)

  • Jang, Kwang-ho;Kwon, Yong-sam;Kim, Jung-eun;Kwon, Eun-ju;Oh, Tae-ho;Lee, Keun-woo;Jang, In-ho
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.635-643
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    • 2000
  • The aim of this study was to determine the effectiveness of carboxymethyl chitosan(CMC) solution on preventing intraperitoneal adhesions. In this study, 44 rats were divided into four groups ; an untreated control group and three experimental groups that were treated with 3 ml of 1, 2 or 3% CMC solution, respectively. The anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $0.5{\times}1cm$ area. The adhesions were blindly assessed 2 weeks later by using a computerized tensiometer. The mean tensile strength(Newton) of formed adhesions was $2.48{\pm}0.88$ in control group, $1.86{\pm}0.56$ in the 1% CMC-treated group, $1.75{\pm}0.71$ in the 2% CMC-treated group and $1.55{\pm}0.60$ in the 3% CMC-treated group. The most favorable prevention against adhesion was achieved in the 3% CMC-treated group(p<0.01). We could conclude that CMC was effective on preventing the formation of postoperative small intestinal adhesions in the rat.

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Ultrasound for Detecting Pleural Adhesion before Video-Assisted Thoracic Surgery (흉부수술전 흉막유착에 대한 초음파검사)

  • Jeong, Jin-Yong;Park, Hyung-Joo;Shin, Jae-Seung;Jo, Won-Min;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.399-403
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    • 2010
  • Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS.

Evaluation of Modified Extraluminal Prostheses Applied to the Trachea in Dogs (개의 기관에 적용한 변형제작한 기관외보철물의 평가)

  • 이충호;우흥명;권오경;남치주
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.1-7
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    • 1999
  • The purpose of the present study was to evaluate the easiness of suture and fixation of modified total ring prostheses (m-TRP). Twelve healthy dogs (B.W.2-10 kg) were randomly assigned to three groups. In group A (3 dogs), total ring prostheses was fixed by penetrating a suture material through tracheal mucosa. In group B (3 dogs), TRP was fixed by suturing on tracheal cartilage and muscular layer not penetrating through tracheal mucosa. m-TRP was applied to the cervical portions (group M-C,3 dogs), and thoracic portions (group M-T,3 dogs). Operating time of group M-C (37.33$\pm$6.80 min.) was shorter than those of groups B (83.33$\pm$8.50 min.) and A (63.33$\pm$11.06 min.) (p<0.01). Clinical complications were minimal and limited to mild, short-term hematoma, vomiting, edema, and inflammation. Coughing remarkably decreased in group B rather than group A. Dyspnea was not showed in group A, B, and M-C, but group M-T had a mild dyspnea. Gross postmortem findings were similar in all groups. Mild adhesions were present between prostheses and adjacent structures, but tracheal lumen was clean. Severe adhesions were present where m-TRP had been applied in the thoracic portions. Histopathologic abnormalities included mild to moderate adventitial and periprosthetic fibrosis and mild adventitial inflammation. The present study indicated that m-TRP were easier in suture and fixation than TRP and had no differences in support for trachea and side effects.

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