Mediastinitis is a life-threatening disease, and effective drainage is needed to treat mediastinitis with abscess formation. We recommend an alternative drainage method using chest tube binding with a Silastic Penrose drainage tube. The use of a Silastic Penrose drainage tube may help to manage mediastinitis with abscess formation. This method facilitates effective draining and prevents tissue adhesion.
Abscess ; Chest Tubes ; Drainage* ; Mediastinitis* ; Tissue Adhesions

Adjustable strabismus surgery sometimes fails because of changes in the angle of deviation which develops a few days after surgery. Therefore, the delayed adjustment was recommended; however, the postoperative tissue adhesion disturbed this delayed adjustment. We studied 20 eyes of 10 rabbits; adjustable strabismus surgery was performed on each of the right lateral rectus muscles by hemichangback technique for control study and the surgery on each left lateral rectus muscle was performed by same methods using polyethylene film. The polyethylene film was wrapped around the muscle allowing it to be placed between the muscle and sclera, and between the muscle and cojunctiva. The mean duration of postoperative tissue adhesion was 1.6 +/- 0.70 days in control group and 18.7 +/- 7.09 days in polyethylene group. These results suggested that the use of polyethylene film provides a valuable resource to defer the adjustment by preventing the postoperative tissue adhesion.
Muscles ; Polyethylene* ; Rabbits* ; Sclera ; Strabismus* ; Tissue Adhesions

OBJECTIVES: Intrauterine adhesions (IUA) refers to the adhesions between the myometrium of the uterine cavity, which is secondary to damage to the basal layer of the endometrium due to trauma or infection. The occurrence of IUA is mainly related to intrauterine operations. Hysteroscopic adhesiolysis (HA) is the standard surgical treatment for IUA. But the recurrence rate of IUA after HA is still high. Importantly, endometrium recovery is difficult, resulting in unsatisfied prognosis for moderate to severer IUA patients. Therefore, it is important to take effective primary preventive measures against the etiology to avoid endometrium damage from medical surgery. In this paper, we discuss and analyze predilection and severer sites of intrauterine adhesions, aiming to provide a basis for how to avoid and reduce injuries during intrauterine operations, such as abortion, dilation and curettage. METHODS: In this study, we retrospectively analyzed the surgical videos of patients who underwent HA for the first time from January 2019 to December 2021 in the Third Xiangya Hospital of Central South University so as to assess the area of adhesions and predilection and severer sites of occurrence of adhesions, and we collected 657 patients who underwent HA for the first time, including 81 patients with total IUA and 576 patients with partial IUA. We counted and analyzed the number and composition ratio of partial IUA patients with severer sites of damage to the lateral wall of the uterine cavity and severerr sites of damage to each segment of the uterine cavity. RESULTS: Among 576 patients with partial IUA, there were 60 patients with no significant difference in the degree of adhesions between the right and left sides, 143 patients with severer adhesions on the left side of the uterine cavity, and 373 patients with severer adhesions on the right side of the uterine cavity. There was a difference in the severity of damage of left and right lateral wall. The proportion of patients with severer adhesions on the right side of the uterine cavity (64.8%) was higher than that of patients with adhesions on the left side of the uterine cavity (24.8%), and there was statistically difference (P<0.05). There was 93 patients with severer adhesions at the fundus or bilateral horn of the uterus, 190 patients with severer adhesions at the middle and upper part of the uterine cavity, 245 patients with severer adhesions at the middle and lower part of the uterine cavity and at the endocervix, and 48 patients with no significant difference in the degree of adhesions in each part. The proportion of patients with severer adhesions at the middle and lower part of the uterine cavity and at the endocervix was higher (42.5%) than those with adhesions in the fundus or bilateral horn of the uterus (16.1%) and in the middle and upper part of the uterine cavity (33.0%), and there were statistically differences (both P<0.05). CONCLUSIONS The predilection site of IUA is the lateral wall of the uterine cavity. The severer adhesions is in the right lateral wall of the uterine cavity, the middle and lower segments and the endocervix, which may be related to the operating habits of the surgeon. Therefore, gynecologists should minimize damage to the lateral wall of the uterine cavity, especially the right lateral wall in performing uterine operations (more attention should be paid by right-handed physicians). Besides, we should pay attention to protecting the middle and lower segments of the uterine cavity and the endocervix, avoiding maintaining negative pressure to withdraw the uterine tissue suction tube from the uterine cavity during abortion procedures to minimize damage.
Humans ; Retrospective Studies ; Tissue Adhesions ; Uterus/pathology*

OBJECTIVES: Although hysteroscopic adhesiolysis (HA) is the main treatment for intrauterine adhesion (IUA), postoperative management of IUA remains challenging because there is no consensus on how to mitigate the high rate of postoperative adhesions reformation. This study aims to compare the effectiveness and safety of 2 types of intrauterine stents with different thickness and hardness in treating moderate-to-severe IUA. METHODS: A retrospective clinical study was conducted in the Third Xiangya Hospital of Central South University from November 2020 to July 2021. A total of 191 patients with moderate-to-severe IUA who received surgical treatment and placed intrauterine stents after HA to prevent recurrence of postoperative adhesions were included. According to the hardness and thickness of the intrauterine stents, the participants were divided into a case group (placed the novel thin intrauterine stent, n=62) and a control group (placed the conventional stent, n=129). After 2-3 menstrual cycles, a second-look hysteroscopy was performed, and the intrauterine stents were removed. The postoperative efficacy [the reduction of American Fertility Society (AFS) scores, the adhesions reformation rate, the changes in menstrual pattern, and the pregnancy rate during the follow-up], safety (the adverse events), and applicability (the difficulty of stent removal) were compared between the 2 groups. RESULTS: No significant differences in preoperative clinical characteristics were observed between the 2 groups (all P>0.05). The menstrual volume of all patients was increased after the treatment. The reduction of AFS scores and the menstruation recovery rate were not significantly different between the 2 groups (P=0.519 and P=0.272, respectively). Notably, there was no case of displacement in the case group, while the displacement rate of the control group was 2.3% (P=0.552). Moreover, there was no significant difference in abdominal pain or postoperative abnormal vaginal bleeding between the 2 groups (P=0.823 and P=0.851, respectively). However, the difficulty rate of removing the thinner stents was significantly lower than that of removing the traditional stent (21.0% vs 38.8%, P=0.014). During the follow-up for half a year of the postoperative period, the pregnancy rate did not differ significantly in the case and control groups (45.0% vs 34.6%, P=0.173). CONCLUSIONS The novel intrauterine stent shows noninferior efficacy and had a good safety profile compared with conventional stents in treating moderate-to-severe IUA. Importantly, it was more convenient to be removed without increasing the rate of displacement and detachment. Therefore, it could reduce the amount of damage to the endometrium and has higher applicability than conventional stents.
Humans ; Retrospective Studies ; Tissue Adhesions ; Uterus/pathology*

The purpose of this study was to evaluate the effect of the alginic acid sodium salt on the delayed adjustable strabismus surgery by preventing the post operative tissue adhesion. 30 eyes of 15 rabbits had received an adjustable suture surgery. The alginic acid sodium salt of 4% was used during operation in 16 eyes among them by injecting it around the muscle, between the sclera and the conjunctiva. In the 3rd, 5th, 7th, 10th, and 14th day postoperatively, we measured the pulling forces and the moving distances of the muscles during the adjustment. Then the eyes were enucleated and the histopathologic changes of the eyes were determined using the light microscope. The pulling forces and the moving distances of the muscles during the adjustment were significantly different between the alginic acid sodium salt free group and the alginic acid sodium salt used group. In the alginic acid sodium salt used group, the pulling forces were decreased and the moving distances were increased than those of the alginic acid sodium salt free group. The light microscopic examination showed more fibrosis in the alginic acid sodium salt free group than in the alginic acid sodium salt used group. These results suggest that the alginic acid sodium salt is an effective substance for the delayed adjustable suture surgery.
Conjunctiva ; Fibrosis ; Muscles ; Rabbits ; Sclera ; Sodium* ; Strabismus* ; Sutures ; Tissue Adhesions

We evaluated histopathologically the effect of the viscoelastic substance on surgery of the extraocular muscle in the 26 rabbits with 1. 6-2. 5kg of weight. The viscoelastic substances were 1% sodium hyaluronate(Healon) and 2% hydroxypropyl methylcellulose(Methocel), which were introduced between the extraocular muscle and its adjacent tissue on surgery. The rabbits were categorized by group 1(the rabbits with Healon), group 2(with Methocel), and group 3(with normal saline as control). These rabbits were enuclated at 3rd, 7th, 14th, 28th and 56th day following operations, and the eyes were fixed in 2.5% glutaraldehyde solution. The tissue was stained with hematoxylin-eosin and Masson's trichrome, and examined under a light microscope. The results were as follows: 1. In the first group(Healon), the tissue adhesion and degeneration of the muscle were milder than those of control(saline) group. 2. The changes in second group(Methocel) was milder than in the first group and more severe than in control group. 3. It is concluded that 2% Methocel can be used clinically in the surgery of the extraocular muscle.
Glutaral ; Methylcellulose ; Muscles* ; Rabbits ; Sodium ; Tissue Adhesions ; Viscoelastic Substances

PURPOSE: The purpose of the experiment with the rabbit was to evaluate the effect of human amniotic membrane transplantation in the extraocular muscle surgery area after the operation. METHODS: Five millimeters resection of both superior rectus muscles was performed in eight rabbits. The left eye was served as a control, and the right eye was covered with human amniotic membrane at the site where the operation was performed. Each rabbit was graded according to the degree of adhesion. A histological comparison was done after enucleation. RESULTS: At one week after the operation, it was discovered that the inflammation of the human amniotic membrane transplantation site was suppressed, but at two weeks the human amniotic membrane transplantation site was significantly inflamed. However, the inflammation decreased at six weeks. CONCLUSIONS: This study shows that strabismus surgery with transplantation of human amniotic membrane may reduce postoperative inflammation and adhesion in strabismus surgery after one week. However, after two weeks the inflammation will increase and produce more postoperative adhesion. After six weeks there was no significant inflammation in comparison to the control group.
Amnion* ; Humans ; Inflammation ; Muscles ; Rabbits* ; Strabismus* ; Tissue Adhesions*

PURPOSE: The role of the amniotic membrane with or without heparin was investigated with regard to the prevention of adhesion formation following flexor tenorrhaphy of chicken. MATERIALS AND METHODS: We classified twelve chickens into four groups of three chickens. In group A, the flexor tendon was partially cut and the tendon was repaired. In group B, The repaired tendon was covered with heparin. In group C, the repaired tendon was covered with amniotic membrane. In group D, the repaired tendon was covered with amniotic membrane and heparin. Histologic and gross findings of the repaired tendon were evaluated at postoperative 3, 6 and 9 weeks. RESULTS: In group D, there were less inflammatory cell infiltration and fibroblasts proliferation in all stages. At postoperative 9 weeks of all groups, there were less inflammation and fibroblasts proliferation than those in postoperative 3 and 6 weeks. CONCLUSION: The use of amniotic membrane transplantation and heparin is effective in the prevention of inflammation and adhesion formation following flexor tenorrhaphy of chicken.
Amnion* ; Chickens* ; Fibroblasts ; Heparin* ; Inflammation ; Tendons ; Tissue Adhesions*

PURPOSE: The role of the amniotic membrane with or without heparin was investigated with regard to the prevention of adhesion formation following flexor tenorrhaphy of chicken. MATERIALS AND METHODS: We classified twelve chickens into four groups of three chickens. In group A, the flexor tendon was partially cut and the tendon was repaired. In group B, The repaired tendon was covered with heparin. In group C, the repaired tendon was covered with amniotic membrane. In group D, the repaired tendon was covered with amniotic membrane and heparin. Histologic and gross findings of the repaired tendon were evaluated at postoperative 3, 6 and 9 weeks. RESULTS: In group D, there were less inflammatory cell infiltration and fibroblasts proliferation in all stages. At postoperative 9 weeks of all groups, there were less inflammation and fibroblasts proliferation than those in postoperative 3 and 6 weeks. CONCLUSION: The use of amniotic membrane transplantation and heparin is effective in the prevention of inflammation and adhesion formation following flexor tenorrhaphy of chicken.
Amnion* ; Chickens* ; Fibroblasts ; Heparin* ; Inflammation ; Tendons ; Tissue Adhesions*

Different techniques of peritoneal closure were evaluated on their effect on the development of postoperative adhesions. Sixty rats were divided into 3 groups of 20 and each group was assigned to one technique. The peritoneum was closed in the 2 groups using different techniques; conventional or edge to edge in the first group and everted edges in the second. In the third group, the peritoneum was not closed. This study showed that there was a significant reduction in the development of postoperative adhesions with one closure of the peritoneum. Suturing of the edges of the peritoneum increased the incidence as well as the severity of postoperative adhesions.