PMC5866859_01
Primary surgery with adhesiolysis and subsequent application of 4DryField PH (4DF) in the first elective patient. (a, b) Dissection of extensive intestinal adhesions. (c, d) Application of extracorporeally premixed 4DF gel via syringe (c) and directly from the kidney dish used for premixing the polysaccharide powder with saline solution (d). (e) Application of 4DF powder onto the greater omentum. (f) Transformation of the powder into a gel by drizzling saline solution onto the powder.
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fig1
On the occasion of the present laparotomy, two conglomerates of the small intestine were found (Figures 1(a) and 1(b)). After thorough rinsing of the abdomen, 15 g 4DF premixed as a gel with 180 mL 0.9% saline solution was applied onto the entire small intestine and the peritoneal cavity via a bladder syringe (Figure 1(c)) and directly from the kidney dish used for premixing (Figure 1(d)). Additionally, 5 g 4DF powder was applied on the greater omentum (Figure 1(e)) and moistened with 0.9% saline solution (Figure 1(f)) before closure.
PMC5866859_02
PMC5866859_03
Second-look surgery five days after the primary surgery of the third patient with no indication of new adhesions.
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fig2
The small intestine appeared inconspicuous without indication of new adhesions (Figure 2).
PMC5866859_04
PMC5866859_05