The correlation between the presence of scar tissue and unfavourable clinical outcome and how to prevent the occurence with Adcon Gel
What are adhesions?
Adhesions are fibrotic bands of tissues that connect planes not normally connected and that influence anatomic structures that would otherwise move freely in their tissue planes. A serious and frequent complication of surgical interventions, adhesions develop during the first three to five days, and can require additional surgery and hospitalisation. In lumbar spine surgery, adhesions may lead to recurrent back pain and/or leg pain and associated physical impairment of the patient requiring re-operation, or failed back surgery syndrome (FBSS).
How can adhesions be prevented?
Adcon® Gel provides a physical barrier to inter-tissue adhesions and inhibits fibroblast migration and ingrowth. This results in improved patient rehabilitation, reduced recurrent pain, and decreased number of re-operations as a result of such adhesions.
The design of Adcon® Gel establishes a temporary basal lamina by combining an absorbable, collagen-derived material with a resorbable polyglycan ester. A major function of basal lamina is to provide a physical barrier to certain cells and molecules. Adcon® Gel offers an excellent physical barrier, preventing fibroblast ingrowth.
How is Adcon® Gel applied?
Apply Adcon® Gel adequately in the following areas immediately prior to closure of soft tissue incisions:
- Coat the existing nerve root along all its surfaces (dorsal, ventral, medial, and lateral) and within the radicular foramen;
- Apply Adcon® Gel around the cephalic extent of the nerve root, getting under the exposed surface of the lamina by approximately 1 cm cephalad;
- Apply Adcon® Gel into the space between the dural sac and the posterior longitudinal ligament, both cephalad and caudad to the annular incision;
- If the ligamentum flavum is intact, apply Adcon® Gel over the anterior and posterior surfaces. If the ligamentum flavum has been removed, apply Adcon® Gel over the dura;
- Apply Adcon® Gel into the site of the laminectomy or laminotomy, filling the depth of the site to the level of the anterior surface of the vertebral lamina.