Human fibrinogen/Human antihemophilic factor ⅩⅢ fraction/ Aprotinin solution/Thrombin/Calcium Chloride Hydrate

Air leakage is one of the major complications related to pulmonary surgeries. To reduce this complication, we developed a decyl group (C10)‐modified Alaska pollock gelatin (ApGltn) (C10‐ApGltn) sealant and evaluated its practical performance against commercially available sealants, Beriplast® and DuraSeal®. C10‐ApGltn was synthesized by reductive amination of the amino groups in ApGltn with decanal. C10‐ApGltn was crosslinked with a poly(ethylene glycol)‐based crosslinker to form a tissue sealant. The crosslinking time of the C10‐ApGltn sealant was fast enough for curing on tissue and application as a spray system. Although the percent swelling of C10‐ApGltn and DuraSeal was significantly greater than Beriplast, C10‐ApGltn and DuraSeal exhibited excellent tissue sealing properties on pleura tissue under a long‐term moist condition. Additionally, C10‐ApGltn and DuraSeal did not cause severe inflammatory responses in a rat subcutaneous example. Therefore, C10‐ApGltn sealant had comparable tissue sealing properties to DuraSeal under a moist condition, indicating the potential of C10‐ApGltn sealant for pulmonary surgeries.

Surgical adhesions can lead to significant consequences including abdominopelvic pain, bowel obstruction, subfertility, and subsequent surgery. Although laparoscopic surgery is associated with a decreased risk of adhesion formation, methods to further decrease adhesions are warranted. We systematically reviewed literature addressing the management, prevention, and sequelae of adhesions in women undergoing laparoscopic gynecologic surgery. We searched PubMed, EMBASE, EBSCOhost, and Cochrane Central Register of Controlled Trials and found 6566 records. The primary outcome was adhesion formation. The secondary outcomes were abdominopelvic pain, quality of life, subfertility, pregnancy, bowel obstruction, urinary symptoms, and subsequent surgery. After applying inclusion and exclusion criteria, 52 studies remained for qualitative synthesis. Risk of bias assessments were applied independently by 2 authors. There was evidence that Hyalobarrier Gel (Anika Therapeutics, Bedford, MA), HyaRegen NCH Gel (Bilar Medikal, Istanbul, Turkey), Oxiplex/AP Gel (Fziomed, Inc., San Luis Obispo, CA), SprayGel (Confluent Surgical Inc., Waltham, MA), and Beriplast (CSL Behring, LLCm King of Prussia, PA) all decrease the incidence of adhesions. Adept (Baxter, Deerfield, IL) significantly decreased de novo adhesion scores of the posterior uterus. Using an integrated treatment approach to pelvic pain significantly improved pain and quality of life compared with standard laparoscopic treatment. Lastly, Hyalobarrier Gel Endo (Anika Therapeutics, Bedford, MA) placement led to a higher pregnancy rate than no barrier usage. Our findings underscore the need for high-quality trials to evaluate the efficacy of surgical techniques, adhesion barriers, and other treatment modalities on the management and prevention of adhesions and their clinical sequelae. This review was registered on PROSPERO (ID = CRD42017068053).