Introduction of Flexible Cyanoacrylates in Sutureless Gastric Closure.

Background Clinical effectiveness and safety of biological and synthetic adhesives in digestive closures have been evaluated. Their use is becoming more prevalent, as rigidity and inflexibility are its more remarkable weaknesses. However, little is known about their role in gastric and anastomotic closures.

Standard Biocompatibility Studies Do Not Predict All Effects of PVA/CMC Anti-Adhesive Gel in vivo.

Purpose: PVA/CMC (polyvinyl alcohol/carboxymethyl cellulose) hydrogel fulfills various physiochemical properties required for an adhesion barrier and has shown good anti-adhesion properties in previous in vivo studies. In this investigation, we assessed the in vitro and in vivo biocompatibility of PVA/CMC gel and compared this to the functionality and promotion of wound healing for two surgical indications.

Methods: Standardized ISO10993 in vitro and in vivo biocompatibility studies, comprising cytotoxicity, genotoxicity, acute systemic toxicity, delayed contact and maximization sensitization test, intracutaneous reactivity and local muscle implantation, were performed on PVA/CMC gel.

A-Part Gel, an adhesion prophylaxis for abdominal surgery: a randomized controlled phase I-II safety study [NCT00646412].

Background: Intra-abdominal surgical intervention can cause the development of intra-peritoneal adhesions. To reduce this problem, different agents have been tested to minimize abdominal adhesions; however, the optimal adhesion prophylaxis has not been found so far. Therefore, the A-Part(®) Gel was developed as a barrier to diminish postsurgical adhesions; the aim of this randomized controlled study was a first evaluation of its safety and efficacy.

Long-term active antimicrobial coatings for surgical sutures based on silver nanoparticles and hyperbranched polylysine.

The goal of this study was to develop a long-term active antimicrobial coating for surgical sutures. To this end, two water-insoluble polymeric nanocontainers based on hyperbranched polylysine (HPL), hydrophobically modified by either using glycidyl hexadecyl ether, or a mixture of stearoyl/palmitoyl chloride, were synthesized. Highly stabilized silver nanoparticles (AgNPs, 2-5 nm in size) were generated by dissolving silver nitrate in the modified HPL solutions in toluene followed by reduction with L-ascorbic acid.

In vitro degradation and drug release of a biodegradable tissue adhesive based on functionalized 1,2-ethylene glycol bis(dilactic acid) and chitosan.

Biodegradability and adhesive-associated local drug release are important aspects of research in tissue adhesive development. Therefore, this study focuses on investigating the in vitro degradation and drug release of a tissue adhesive consisting of hexamethylene diisocyanate functionalized 1,2-ethylene glycol bis(dilactic acid) and chitosan chloride. To prevent infections, ciprofloxacin hydrochloride (CPX·HCl) was incorporated into the adhesive.

In vivo knot scoring model for a multifilament suture.

Background: A surgical knot is the key feature to assure appropriate wound support while combining tissue edges. Little evidence is available on the in vivo behavior of knots and the evaluation of knots in the living tissue. This study introduces a knot score model, which is defined by microscopic evaluation and the loop-holding capacity.

Development of a biodegradable tissue adhesive based on functionalized 1,2-ethylene glycol bis(dilactic acid). II.

In body regions where damage and bleeding must be avoided, a substitute for mechanical tissue fixation by sutures or staplers is needed. Since tissue adhesives provide easy and fast handling they are a promising alternative. The present study reports the development and analysis of a tissue adhesive that consists of two adhesive components: hexamethylene diisocyanate (HDI) functionalized 1,2-ethylene glycol bis(dilactic acid) (ELA-NCO) and chitosan chloride.

A hydrogel for adhesion prevention: characterization and efficacy study in a rabbit uterus model.

Objective: Postoperative peritoneal adhesions following gynaecological surgery remain a clinically relevant problem. One approach to prevent adhesion formation is to apply physical barriers such as hydrogels.

Study Design: A physically crosslinked polyvinyl alcohol and carboxymethylcellulose (PVA/CMC) hydrogel (A-Part) was characterized in vitro.

Development of a biodegradable tissue adhesive based on functionalized 1,2-ethylene glycol bis(dilactic acid). I.

Tissue adhesives are a valuable alternative for mechanical tissue fixation by sutures or staples. Adhesives are desirable in body regions where damage and bleeding must be avoided. Tissue adhesives provide easy and fast handling.

The new adhesion prophylaxis membrane A-part--from in vitro testing to first in vivo results.

Introduction: Formation of postoperative intra-abdominal adhesions is a severe problem in surgery. Apart from standard surgical procedures, a variety of different substances is available to prevent adhesions, but no universal method has been developed so far. A membrane consisting of polyvinyl alcohol (PVA) and carboxymethylcellulose (CMC) has been demonstrated to be antiadhesive.

Polyvinyl alcohol gel prevents adhesion re-formation after adhesiolysis in a rabbit model.

Background: Chronic pain, infertility, and bowel obstructions are possible consequences of abdominal adhesions, which can highly affect the patient's quality of life. Patients in whom adhesiolysis has been performed are at high risk for recurrence of adhesions. For that reason, the present study focused on the re-formation of adhesions after adhesiolysis and on the possibility of avoiding it by using the adhesion barrier polyvinyl alcohol (PVA)-gel.

Polyvinyl alcohol gel prevents abdominal adhesion formation in a rabbit model.

Objective: To evaluate the function and biocompatibility of the new adhesion barrier PVA gel (polyvinyl alcohol + carboxymethylated cellulose) in the prevention of postsurgical peritoneal adhesions in a rabbit sidewall model. To evaluate and compare the routinely used 4% icodextrin.

Design: A prospective randomized controlled study was designed to evaluate the effectiveness of PVA gel in reducing postoperative adhesion formation.

Tracking the urinary excretion of high molar mass poly(vinyl alcohol).

The fate of poly(vinyl alcohol) (PVA) of weight average molar mass of 125,000 g/mol after administration into the peritoneum of rabbits has bean studied by various methods. PVA was spin-labeled with a nitroxide radical and then detected in urine using electron spin resonance (ESR) spectroscopy. Furthermore, unlabeled polymer was also administered to rabbits, then the urine was collected, dialyzed, precipitated, and the excretion of PVA was confirmed by size exclusion chromatography (SEC), FTIR spectroscopy, and (1)H NMR spectroscopy.

A-part gel-an efficient adhesion prevention barrier.

Two different poly(vinyl alcohol)-based gels (A-Part Gel) were compared and evaluated as possible adhesion prophylaxis gels. The gels were implanted to act as a physical barrier-and thus to prevent adhesions-in a rabbit sidewall model. The absorption time of any adhesion barrier is a critical parameter, since the wounded tissue needs to be covered during the healing process.

Poly(vinyl alcohol) membranes for adhesion prevention.

The abnormal joining of anatomic structures after abdominal and pelvic surgery can lead to such major complications as bowel obstruction or infertility. Poly(vinyl alcohol) (PVA) membranes and hydrogels were placed over the injured tissue to act as a physical barrier and prevent such adhesions from occurring in a rabbit sidewall model. The membranes were sutured into place to prevent their slipping or curling on the moist tissue.