Metwally, Mostafa, Cheong, Ying and Li, Tin Chiu
A review of techniques for adhesion prevention after gynaecological surgery
Current Opinion in Obstetrics and Gynecology, 20, (4), . (doi:10.1097/GCO.0b013e3283073a6c). (PMID:18660685).
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Purpose of review: to explore recent developments in the techniques used for the prevention of adhesion formation after gynaecological surgery as well as the current evidence for existing agents and techniques.
Recent findings: recent developments are promising new biomaterials such as polyvinyl alcohol gel and hyaluronic acid cross-linked with various agents such as nanoparticles. Other substances that have recently received attention include novel anti-inflammatory agents, Oxiplex (FzioMed, Inc., San Luis Obispo, California, USA), sildenafil, statins and also, there has been some renewed interest in dextran. Furthermore, the combination of barrier and pharmacological agents has led to the introduction of interesting new hybrid systems. Finally, despite the development of many novel antiadhesion agents, good surgical technique remains the mainstay of adhesion prevention.
Summary: there is preliminary evidence to support the use of hyaluronic acid, although the best preparation is yet to be determined. The use of icodextrin, Interceed (Ethicon Inc, Somerville, New Jersey, USA) and Oxiplex seem to be justified by the currently available data. The results of interesting new technologies such as the use of hybrid systems and new forms of biomaterials are awaited.
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