Elastomeric biomaterials for tissue engineering

Aim: To summarize the most common etiologic factors and describe the pathophysiology in the formation of peritoneal adhesions, to outline their clinical significance and consequences, and to evaluate the pharmacologic, mechanical, and surgical adjuvant strategies to minimize peritoneal adhesion formation. Methods: We performed an extensive MEDLINE search of the internationally published English literature of all medical and epidemiological journal articles, textbooks, scientific reports, and scientific journals from 1940 to 1997. We also reviewed reference lists in all the articles retrieved in the search as well as those of major texts regarding intraperitoneal postsurgical adhesion formation. All sources identified were reviewed with particular attention to risk factors, pathophysiology, clinical manifestations, various methods, and innovative techniques for effectively and safely reducing the formation of postsurgical adhesions. Results: The formation of postoperative peritoneal adhesions is an important complication following gynecological and general abdominal surgery, leading to clinical and significant economical consequences. Adhesion occur in more than 90% of the patients following major abdominal surgery and in 55–100% of the women undergoing pelvic surgery. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain, and difficult reoperative surgery are the most common consequences of peritoneal adhesions. Despite elaborate efforts to develop effective strategies to reduce or prevent adhesions, their formation remains a frequent occurrence after abdominal surgery. Conclusions: Until additional information and findings from future clinical investigations exist, only a meticulous surgical technique can be advocated in order to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery.

Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management.

https://www.surgical.theclinics.com/article/S0039-6109(05)70574-0/pdf

Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers

Intra-abdominal adhesions: cellular mechanisms and strategies for prevention.

Recently there have been increasing research efforts in the development of elastomeric biomaterials with desirable biocompatibility, degradation profiles and mechanical properties for use in soft tissue engineering. This review provides an update on the progresses of developing biodegradable, soft elastomeric biomaterials and their tissue engineering scaffolding techniques. Following a brief review on traditional thermoplastic elastomers, including polyurethane (PU), polyhydroxyalkanoates (PHA) and aliphatic copolyesters, detailed review is devoted to the synthesis, properties and scaffold fabrication of recently developed soft, biodegradable elastomers, including poly(polyol sebacate) (PPS), PPS-based elastomers, and citric-acid based elastomers. Although biodegradable, soft elastomeric biomaterials have advantages (compliant and biodegradable), this review also identified a number of issues associated with these elastomers, including cytotoxicity, rapid in vivo degradation rates, and poor reproducibility. Future research directions are discussed to address these issues.

Biodegradable soft elastomers: synthesis/properties of materials and fabrication of scaffolds

Prevention of Postoperative Adhesions by Single Intraperitoneal Medication

Das Riesenkondylom in anorektaler Lokalisation ist eine extreme Raritat Obwohl der blumenkohlformige Tumor klinisch ein malignes Wachstum zeigt, erfullt er nicht die histomorphologischen Kriterien der Malignitat In der Literatur sind bis heute 33 Falle eines Riesenanorektalkondyloms beschrieben worden, davon 42% mit maligner Transformation in ein Schuppenzellkarzinom Zwei weitere Falle eines invasiven Schuppenzellkarzinoms auf dem Boden eines Riesenzellkondyloms werden berichtet Der Buschke-Loenstein-Tumor ist ein Zwischenstadium des “einfachen” Kondyloms und des Schuppenzellkarzinoms Condylomata acuminata werden durch die humanen Papillomavirus-Typen 6 und 11 verursacht Karzinogene Kofaktoren bewirken den Ubergang in das Riesenkondylom mit lokal destruierendem Wachstum und folgender maligner Transformation Nur die rechtzeitige, lokale, radikale Exzision im Gesunden verspricht therapeutischen Erfolg Multiple Fisteln und die Zerstorung des Sphinkterapparates konnen die abdominoperineale Rektumamputation erforderlich machen Eine Bestrahlung sollte nur erfolgen, um Operabilitat herzustellen, da sie einen kokarzinogen Effekt auf den Tumor aufweist und eine Entdifferenzierung in ein aggressiv wachsendes Karzinom auslost

Invasive squamous-cell carcinoma in giant anorectal condyloma (Buschke-Löwenstein tumor).

Das Riesenkondylom in anorektaler Lokalisation ist eine extreme Raritat. Obwohl der blumenkohlformige Tumor klinisch ein malignes Wachstum zeigt, erfullt er nicht die histomorphologischen Kriterien der Malignitat. In der Literatur sind bis heute 33 Falle eines Riesenanorektalkondyloms beschrieben worden, davon 42% mit maligner Transformation in ein Schuppenzellkarzinom. Zwei weitere Falle eines invasiven Schuppenzellkarzinoms auf dem Boden eines Riesenzellkondyloms werden berichtet. Der Buschke-Loenstein-Tumor ist ein Zwischenstadium des “einfachen” Kondyloms und des Schuppenzellkarzinoms. Condylomata acuminata werden durch die humanen Papillomavirus-Typen 6 und 11 verursacht. Karzinogene Kofaktoren bewirken den Ubergang in das Riesenkondylom mit lokal destruierendem Wachstum und folgender maligner Transformation. Nur die rechtzeitige, lokale, radikale Exzision im Gesunden verspricht therapeutischen Erfolg. Multiple Fisteln und die Zerstorung des Sphinkterapparates konnen die abdominoperineale Rektumamputation erforderlich machen. Eine Bestrahlung sollte nur erfolgen, um Operabilitat herzustellen, da sie einen kokarzinogen Effekt auf den Tumor aufweist und eine Entdifferenzierung in ein aggressiv wachsendes Karzinom auslost.

Invasives Schuppenzellkarzinom beim Riesenanorektalkondylom (Buschke-Löwenstein-Tumor)

Postoperative peritoneal adhesions account for a wide range of clinical symptoms from unspecific abdominal complaints to intestinal obstruction. They make repeated surgery time-consuming and hazardous. This problem increases with longevity, the growing numbers of laparotomies worldwide, and the feasibility of operations on elderly patients. Adjuvant means are needed to reduce the formation of these adhesions.

Experimental Prevention of Peritoneal Adhesions in General Surgery

Eindeutige Karzinomsarkome des Kolons – Fallbericht

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