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Adhesions form when the mesothelial cell layer is disrupted during routine surgery, and fibrin is deposited at the site of injury.(1) In the five days following surgery, this fibrin can form a bridge between adjacent tissue surfaces, upon which connective tissue grows to create an adhesion.(1)

Adept is a 4% solution of the a-1,4 glucose polymer icodextrin, and when used as a post-operative instillate, it creates a liquid barrier between peritoneal tissue surfaces. This process is known as hydroflotation, and helps prevent the formation of adhesions. Adept can also be used as an intra-operative irrigant, preventing any dilution of the post-operative instillate with saline.

Unlike Ringer’s Lactate Solution, icodextrin has a slow rate of absorption(2), and it is not metabolised in the peritoneal cavity so Adept is retained for over 4 days, right through the critical period of adhesion formation, as show in figure 2. (3,4)

To see a short video of Adept and the process of hydroflotation, click here.

References
(1) Holmdahl L. Lancet 1999; 353: 1456-1457
(2) diZerega SG et al. Human Reprod 2002; 17: 1031-1038
(3) Hosie K et al. Drug Deliv 2001; 8: 9-12
(4) Verco SJS et al. Human Reprod 2000; 15: 1764-1772

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