Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 6 Issue 10

Starch-based Hemostatic Powder as a Novel Anti-adhesive Agent

Alp Yildiz1*, Yavuz Pirhan2, Caglar Ozcelik1, Furkan Savas3 and Aybala Yildiz4

1Department of General Surgery, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, Turkey
2Department of General Surgery, Amasya University School of Medicine, Amasya, Turkey
3Department of General Surgery, Bilkent City Hospital, Ankara, Turkey
4Department of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey

*Corresponding Author: Alp Yıldız, Department of General Surgery, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, Turkey.

Received: July 01, 2022; Published: September 05, 2022


Introduction: Adhesions develop after up to 97% of abdominal surgery causing chronic pain and intestinal obstruction. Only a few of hemostatic agents are available for adhesion prevention [2-4]. In this retrospective study we investigated the effectivity of starch based hemostatic powder (SBHP) on preventing postoperative intraabdominal adhesions.

Patients and Methods: This retrospective study comprises 54 patients aged 18-67, who underwent second look laparotomy/laparoscopy in the period from 2018 and 2021. Only patients with a second look surgery were included in the study. Group-1 had been applied hemostatic agent in initial operation as Group-2 had not been applied any agents. On second-look laparotomy adhesions has observed and recorded.

Results: Both median adhesion severity and extent scores in Group-1 were 0.4, and 1.8 in Group-2. The statistical evaluation shows that both severity and extent were significantly reduced from Group-2 to Group-1 when SBHP was used.

Conclusion: In the light of the high efficacy observed in the present study we recommend to take SBHP into consideration as anti-adhesive agent additional to hemostatic product.

Keywords: Adhesion; Surgery; Anti-adhesive


  1. Blumhardt G., et al. “Effect of 4DryField® PH, a Novel Adhesion Barrier, on Recurrence of Intestinal Adhesions after Extensive Visceral Adhesiolysis”. Case Reports in Surgery (2018): 9628742.
  2. Watrowski R. “Unifying local hemostasis and adhesion prevention during gyneacologic laparoscopies: experiences with a novel, plant based agent”. Journal of Obstetrics and Gynaecology4 (2020): 586-588.
  3. Pöhnert D., et al. “Comparison of adhesion prevention efficacy of coated Parietex and Proceed meshes versus uncoated polypropylene mesh combined with anti-adhesion device 4DryField PH in a new IPOM rat model with impaired intestinal peritoneum”. Zeitschrift für Gastroenterologie 54 (2016): 131.
  4. Pöhnert D., et al. “Evaluation of the effectiveness of adhesion prevention devices in a rat model”. Zeitschrift für Gastroenterologie 54 (2016): 132.
  5. MA Weibel and G Majno. “Peritoneal adhesions and their relation to abdominal surgery: a postmortem study”. American Journal of Surgery3 (1973): 345-353.
  6. MP Diamond and ML Freeman. “Clinical implications of postsurgical adhesions”. Human Reproduction Update6 (2001): 567–576.
  7. K H Treutner., et al. “Causes of intestinal obstruction—a retrospective study of 550 surgical cases”. in Peritoneal Adhesions, K.-H. Treutner and V. Schumpelick, Eds., pp. 191–194, Springer, Berlin, Germany, (1997).
  8. Ziegler N and De Wilde RL. “Reduction of adhesion formation after gynaecological adhesiolysis surgery with 4DryField PH - a retrospective, controlled study with second look laparoscopies”. Journal of Obstetrics and Gynaecology 4 (2022): 658-664.
  9. Korell M., et al. “Use of modified polysaccharide 4DryFieldVR PH for adhesion prevention and hemostasis in gynecological surgery: a two-center observational study by second-look laparoscopy”. BioMed Research International (2016): 1-9.
  10. Kavic SM., et al. “Adhesions and adhesiolysis: the role of laparoscopy”. JSLS: Journal of the Society of Laparoendoscopic Surgeons 6 (2002): 99-109.
  11. Raimondo D., et al. “Cellulose absorbable barrier for prevention of de-novo adhesion formation at the time of laparoscopic myomectomy: a systematic review and meta-analysis of randomized controlled trials”. European Journal of Obstetrics and Gynecology and Reproductive Biology 245 (2020): 107-113.
  12. Korell M. “Combined hemostasis and adhesion prevention with the novel agent 4DryFieldVR PH—initial observations”. Surgical Science 5 (2014): 533-539.
  13. Hanke AA., et al. “Effects of a New Microporous Polysac- charide Powder on Viscoelastic Characteristics of Clot Formation. American Society of Anesthesiologists Annual Meeting 2011”. Anesthesiology (2011).
  14. Poehnert D., et al. “Marked Reduction of Peritoneal Adhesion Formation in Rat Model of Cecal Abrasion by a Novel Anti-Adhesive Agent, 4DryField® PH: 131st Congress of the German Society for Surgery”. Langenbeck’s Archives of Surgery 399 (2014): 371-413.
  15. Ziegler N., et al. “Changed inflammatory markers after application of 4DryField PH for adhesion prevention in gynecological surgery”. Archives of Gynecology and Obstetrics 4 (2021): 951-955.


Citation: Alp Yildiz., et al. “Starch-based Hemostatic Powder as a Novel Anti-adhesive Agent”.Acta Scientific Medical Sciences 6.10 (2022): 10-12.


Copyright: © 2022 Alp Yildiz., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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