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The use of hyaluronic acid/carboxymethyl cellulose (HA/CMC) membrane, reduces the incidence, extent and severity of adhesions in the abdomen.

Adhesions in the abdomen cause abnormal bonding between adjacent peritoneal surfaces and are common after operations in the abdomen. They are composed of fibrous tissue but also contain blood vessels, fat and nerves. They result in a spectrum of problems that affect the patient (intestinal blockage, infertility and possibly pain); the surgeon (difficulties in access and dissection, prolongation of operative time, increase in blood loss, predisposition to bowel injury); the health care provider (increased cost due to readmissions and litigation). Prevention is the key. This review focus on the evaluation of the safety and efficacy of two preventive agents applied in the abdomen during general surgical operations, Hyaluronic acid /carboxymethyl cellulose membrane and 0.5% ferric hyaluronate gel.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Drug Class Review: Nasal Corticosteroids: Final Report Update 1 [Internet]

Nasal corticosteroids are a safe and effective treatment option for both allergic and non-allergic rhinitis. There are currently 8 different nasal corticosteroid preparations on the U.S. market. The nasal sprays differ with respect to delivery device and propellant, as well as potency and dosing frequency. The purpose of this review is evaluating the comparative evidence on the benefits and harms of the nasal corticosteroids to help policy makers and clinicians make informed choices.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2008
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Barrier agents for adhesion prevention after gynaecological surgery

This review of trials assessed the effects of barriers agents on pelvic pain, live birth and adhesion formation after pelvic surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Agents that prevent the development of abdominal adhesions following surgery: an overview of Cochrane reviews

Abdominal adhesions are web like structures that commonly form following abdominal or pelvic surgery. They are a result of damage to the lining of the abdomen and can cause multiple conditions such as chronic pelvic pain and infertility. Many types of solid, liquid, gel and pharmacological agents have been developed which, when applied during surgery, supposedly reduce the chance that adhesions will develop. However, there has been considerable disagreement as to which agent is more effective. We aimed to summarise the evidence from Cochrane Reviews regarding anti‐adhesion agents in gynaecological surgery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgical Site Infection: Prevention and Treatment of Surgical Site Infection

Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: October 2008
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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®): Health Professional Version

Expert-reviewed information summary about oral complications, such as mucositis and salivary gland dysfunction, that occur in cancer patients treated with chemotherapy or radiation therapy to the head and neck.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 16, 2016

Skin Substitutes for Treating Chronic Wounds [Internet]

A wide variety of wound care products are available for clinicians to choose from when treating chronic wounds. Many of these products are said to mimic or substitute for some aspect of the skin's structure and function to promote healing and wound closure. The materials used to produce these products may be derived from human or animal tissue and may undergo extensive or minimal processing to make the finished product. The extent of processing and the source of the material used in the product also determines what regulatory pathway may be required before the product can be marketed. CMS requested this report on the types of wound care products that are commonly referred to as “skin substitutes” and on the regulatory pathways required for the different types of products. For this report, we have not created a definition for a skin substitute product. Instead we used the products listed under CMS codes Q4101 to Q4122 as a starting point and looked for similar products listed in the U.S. Food and Drug Administration (FDA) product codes to generate a list of products. We included only those products indicated for chronic wounds. We note that FDA does not refer to any product or class of products as “skin substitutes,” and we are not proposing an official classification system.

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: December 18, 2012
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Advanced Wound Care Therapies for Non-Healing Diabetic, Venous, and Arterial Ulcers: A Systematic Review [Internet]

Chronic ulcers (i.e., ulcers that are unresponsive to initial therapy or that persist despite appropriate care) are estimated to affect over 6 million people in the United States. The incidence is expected to increase as the population ages and as the number of individuals with diabetes increases. Chronic ulcers negatively affect the quality of life and productivity of the patient and represent a substantial financial burden to the health care system.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: November 2012
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Dressings and Care of Skin Graft Sites: A Review of Clinical Evidence and Guidelines [Internet]

A skin graft is sheet of skin harvested from a donor site; it may include the epidermis and part of the dermis (split thickness skin graft) or both the epidermis and dermis (full thickness graft) to cover skin lost due to surgery or trauma. Dressings are used to cover the donor site or the grafted skin; this is done to enhance healing, improve patients’ comfort and reduce the pain. Skin dressings can be broadly classified into medicated and non-medicated dressings. Medicated dressings include hydrocolloid dressings, hydrogel dressings. alginate dressings, fibrous absorbent dressings, dressings that contribute to odour management, antimicrobial dressings, and Manuka Honey dressings. The non-medicated dressings include vapour permeable dressings, foam dressings, low adherent dressings, non-adherent wound contact layers, atraumatic absorbent dressings, post-operative dressings, and hydrocapillary dressings. Dressing change may be a traumatic experience for patients and can tax healthcare resources. Pain and discomfort of patients while the dressing is in place and during dressing change may be related to the characteristics of the wound dressing used. Furthermore, dressing type may affect the incidence of wound infection which would affect the frequency of dressing change and the overall success of the skin graft procedure.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: December 19, 2013
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Strategies in the prevention of the formation of postoperative adhesions in digestive surgery: a systematic review of the literature

BACKGROUND: Postoperative intra-abdominal adhesions after GI surgery constitute a major burden for health care provision globally, causing chronic abdominal symptoms and necessitating repeated surgical intervention.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy and safety of seprafilm for preventing postoperative abdominal adhesion: systematic review and meta-analysis

BACKGROUND: There is no clear consensus on the efficacy and safety of hyaluronate-carboxymethylcellulose membrane (Seprafilm) for preventing postoperative abdominal adhesion. This study is a meta-analysis of the available evidence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Benefits and harms of adhesion barriers for abdominal surgery: a systematic review and meta-analysis

This review assessed the benefits and harms of four adhesion barriers for abdominal surgery and concluded that evidence suggests that oxidised regenerated cellulose and hyaluronate carboxymethyl cellulose reduce adhesion formation. This was a well conducted review but the evidence base was limited in size and by heterogeneity, which means that the reliability of the findings is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Systematic Reviews in PubMed

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