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Adhesion prevention after extensive bowel adhesiolysis

To cover all wound surfaces of the extensive adhesiolysis procedure, a large volume of premixed gel (made from 3×5 g 4DryField^® PH powder and approx. 200 ml saline) was applied. 4DryField^® PH’s excellent capabilities to prevent adhesion recurrence after bowel adhesiolysis have been examined in publications by Blumhardt et al. (2018, https://downloads.hindawi.com/journals/cris/2018/9628742.pdf) and Ahmad & Crescenti (2019, https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0039-1687857.pdf).

Adhesion prevention and hemostasis after removal of an ovarian cyst

To preserve fertility after removal of ovarian cysts, it is advisable to replace cauterization (as it destroys follicle containing tissue) and prevent adhesions (as these are a common cause of secondary infertility).

4DryField^® PH can effectively replace cauterization leading to significantly higher AMH levels after cyst removal (Moszynski et al. 2023, https://www.mdpi.com/1648-9144/59/1/14), as well as effectively reduce adhesion formation by about 85% (Torres-de la Roche et al. 2020, https://link.springer.com/article/10.1007/s00404-020-05483-9).

Adhesion prevention after removal of an ovarian dermoid cyst

A premixed gel from 3g 4DryField^® PH powder and approx. 30 ml saline solution is applied on the ovarian suture site.
Adhesions after ovarian cyst removal are a common cause of secondary infertility and 4DryField^® PH gel has been shown to reduce these by about 85% (Torres-de la Roche et al. 2020, https://link.springer.com/article/10.1007/s00404-020-05483-9).

Adhesion prevention and hemostasis after endometriosis resection with second look

A randomized controlled trial about adhesion prevention with 4DryField^® PH after resection of deep infiltrating endometriosis showed significant adhesion reduction by 85% (Krämer et al. 2021a, https://link.springer.com/content/pdf/10.1007/s00423-021-02193-x.pdf) and a significantly higher fertility rate after 12 months (Krämer et al. 2021b, https://www.mdpi.com/2077-0383/12/10/3597).

Adhesion prevention and hemostasis after endometriosis resection

A randomized controlled trial about adhesion prevention with 4DryField^® PH after resection of deep infiltrating endometriosis showed significant adhesion reduction by 85% (Krämer et al. 2021a, https://link.springer.com/content/pdf/10.1007/s00423-021-02193-x.pdf) and a significantly higher fertility rate after 12 months (Krämer et al. 2021b, https://www.mdpi.com/2077-0383/12/10/3597).

Adhesion prevention and hemostasis after adhesiolysis and removal of endometriosis and endometriomas

A randomized controlled trial about adhesion prevention with 4DryField^® PH after resection of deep infiltrating endometriosis showed significant adhesion reduction by 85% (Krämer et al. 2021a, https://link.springer.com/content/pdf/10.1007/s00423-021-02193-x.pdf) and a significantly higher fertility rate after 12 months (Krämer et al. 2021b, https://www.mdpi.com/2077-0383/12/10/3597).

Furthermore, a controlled trial after gynecologic adhesiolysis surgery showed that adhesiolysis alone did not reduce adhesion severity or extent, whereas the usage of 4DryField^® PH gel after adhesiolysis led to a significant reduction of both (Ziegler & De Wilde 2022, https://www.tandfonline.com/doi/pdf/10.1080/01443615.2021.1928030).

Hemostasis and adhesion prevention after hysterectomy

Combined application of 4DryField^® PH powder for hemostasis and transformation into gel for adhesion prevention in hysterectomy surgery.

Hemostasis and adhesion prevention during implantation of an intraperitoneal onlay mesh

The gel is prepared through dripping of applied 4DryField^® PH powder on the intestine opposing the mesh. This way, when pressure is released form the abdominal cavity at the end of the intervention, the net sinks onto the gel preventing intestine to mesh adhesions.
The combination of 4DryField^® PH gel with uncoated meshes delivered significantly better adhesion reduction rates than the usage of precoated meshes in a study by Winny et al. (2016, https://www.medsci.org/v13p0936.pdf?v=1597757474).

Adhesion prevention after myomectomy

A premixed gel with a relative high viscosity is applied for adhesion prevention. For this, a mixing ration of about 8 ml saline per gram of 4DryField^® PH powder is used.

Preparation of premixed 4DryField^® PH gel in a bowel

A common mixing ratio for premixed 4DryField^® PH gel is about 10 ml saline per gram of powder. For a higher viscosity the volume of saline solution can be lowered to 8 ml per gram (Korell et al. 2016, https://downloads.hindawi.com/journals/bmri/2016/3029264.pdf), for a lower viscosity up to 14 ml per gram can be used (Blumhardt et al. 2018, https://downloads.hindawi.com/journals/cris/2018/9628742.pdf).

Premixed 4DryField^® PH gel remains stable for some time so that it can be prepared well in advance of application if sterility is ensured.

Preparation of premixed 4DryField^® PH gel in a syringe

A common mixing ratio for premixed 4DryField^® PH gel is about 10 ml saline per gram of powder. For a higher viscosity the volume of saline solution can be lowered to 8 ml per gram (Korell et al. 2016, https://downloads.hindawi.com/journals/bmri/2016/3029264.pdf), for a lower viscosity up to 14 ml per gram can be used (Blumhardt et al. 2018, https://downloads.hindawi.com/journals/cris/2018/9628742.pdf).

Premixed 4DryField^® PH gel remains stable for some time so that it can be prepared well in advance of application if sterility is ensured.

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