Use of 4DryField® PH for adhesion prevention:

Using the bellows applicator, spray 4DryField® PH generously onto all areas that need to be protected from adhesions. Then sprinkle the 4DryField® PH with isotonic saline solution until a gel completely covers the affected surface. To achieve optimum results, the 4DryField® PH gel should generously cover all of the areas that need to be protected from the formation of adhesions.

To obtain the best possible adhesion prevention, there should also be no free blood on the site that could mix with the 4DryField® PH gel. Fibrin or other blood components that contaminate the gel can cause the treatment to be unsuccessful. Therefore, please ensure that sufficient haemostasis has been achieved before going ahead with the adhesion prevention.


4DryField® as a gel significantly reduces adhesion formation by 93 %.1


You can find further information on the product and its use for adhesion prevention in the current 4DryField® PH package information leaflet. Endoscopy and laparoscopy: 4DFLapTM is a single use applicator for manual administration of 4DryField® PH in endoscopic and laparoscopic surgery.


The following video shows an example of the use of 4DryField® PH to prevent (re-)adhesions; 4DryField® PH is applied as a powder and then transformed into a gel (hernia).




Extracorporeal gel preparation:

Extracorporeal gel preparation was introduced by Dr. Blumhardt (Unna) and is now also used by other surgeons. The following video shows Dr. Blumhardt’s technique for extracorporeal gel preparation with a 0.9% saline solution (5g 4DryField® PH + 60ml saline solution). He very successfully uses this procedure to treat patients after an adhesiolysis, for example, where the entire abdomen was previously immobilised by adhesions.



The following video shows how 4DryField® PH can be mixed extracorporeally.



Extracorporeal gel preparation in the field of gynaecology has been described in a recent publication (Korell et al. 2016). The authors Korell, Ziegler and De Wilde highlighted this form of gel preparation in a mixing ratio of 40 ml 0.9% saline solution per 5g 4DryField® PH as an effective and successful method.

Poehnert et al. (2015a) and Poehnert et al. (2016) used a mixing ratio of 5g 4DryField® PH with 20ml 0.9% saline solution in their studies.

 

What quantity of 4DryField® PH should be used for adhesion prevention?

The quantity of 4DryField® PH required depends on the surgical situation. It must be ensured that all areas needing protection are covered with 4DryField® PH gel. Up to 1g 4DryField® PH per kilogram of body weight can be used (Poehnert et al. 2015b).


If you have any questions on 4DryField® PH, you would like to discover new areas of application, or you’d like to share your experiences with 4DryField® PH, please feel free to contact us.


4DryField® PH is delivered as a powder and is transformed into a gel in situ. Please note, that for adhesion prevention the transformation of the powder into a gel (with saline solution, 0,9 %) is absolutely necessary! 4DryField® PH special features make it easy to use in open as well as in laparoscopic surgery.


 1 Poehnert et al. 2016 Int J Med Sci