TITLE:
Combined Hemostasis and Adhesion Prevention with the Novel Agent 4DryField® PH—Initial Observations
AUTHORS:
Matthias Korell
KEYWORDS:
Hemostasis, Adhesion Prevention, Polysaccharide, Gynecological Surgery
JOURNAL NAME:
Surgical Science,
Vol.5 No.12,
December
15,
2014
ABSTRACT: Large size peritoneal
trauma from extended surgery for high-grade expansive uterus pathology or
endometriosis might result in severe diffuse bleeding and peritoneal adhesion
formation with objectionable sequelae. This paper introduces 4DryField®PH polysaccharide powder certified for
two indications: 1) given as powder 4DryField®PH provides hemostasis; 2) transformed
into gel, 4DryField®PH
forms an adhesion prevention barrier. Twenty-one women with expanded uterus
pathology and/or deep infiltrating endometriosis had surgery including repair
of intestine lesions (n = 8), ureterolysis/repair of bladder, including
retrograde ureteric stents (n = 5). Subjective impression of hemostatic effect,
drain loss and infection parameters were recorded. Six women had scheduled
second look laparoscopy. 4DryField®PH applied as powder showed an
immediate significant hemostatic effect in all instances, especially in
profound diffuse bleeding. Mean drain loss was 497 ± 339 mL, moderate
considering the extent of disease. Dripped with saline solution, 4DryField®PH immediately formed a viscous gel
acting as a barrier for adhesion prevention. Second look laparoscopy revealed
only one patient with significant adhesions. No adverse events were observed;
discharge was at Day 6.2 ± 1.4. In this cohort with extended gynecological
laparoscopic surgery 4DryField®PH
was very effective for hemostasis. The results of second look laparoscopies
showed mainly no or minor adhesions. This can be considered very favorable
regarding the extent of disease in these patients. Considering the twofold
effect in hemostasis and adhesion prevention, 4DryField®PH is a very helpful tool especially
in extensive and complicated surgeries. Prospective randomized
studies are necessary to prove these promising results in larger series.