Comments on: FDA Approves Adhesion Prevention Solution for Surgery http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/ transforming medicine with tomorrow’s technology Thu, 20 Nov 2008 18:41:55 +0000 http://wordpress.org/?v=2.5 By: ragini http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-16249 ragini Sun, 17 Jun 2007 11:59:16 +0000 http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-16249 why it is withdrawn from indian market why it is withdrawn from indian market

]]> By: Steven F. Palter, MD http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-2831 Steven F. Palter, MD Sat, 10 Feb 2007 02:21:22 +0000 http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-2831 Thanks for your post but you are mistaken and notr correct. Hyskon (Goodness- I haven't used that crap since 1994) is actually 32 percent dextran-70. THe complications from Hskon are not due to its mechanism of action. The complications were rare and were mainly allergic. Case reports suggested that Dextran 70 may cause a syndrome resembling disseminated intravascular coagulation -- very rare. The allergic response to Hyskon consists of both an anaphylactic and an anaphylactoid component. The pulmonary edema and fluid overload was rare as well. The problem with it was it was like glue when it dried and it simply did not work well at all when tested for adhesion prevention and for hysteroscopy was very limited in what could be done with it vs saline glycine etc. in prospective trials. Yes, I was not 100% clear when I drew the comparison of the two products. The mechanism of hyskon drawing fluid into the peritoneum and Adept staying put without absorption is "technically different" but THEY BOTH PREVENT ADHESIONS VIA THE SAME MECHANISM - namely the "hydroflotation" mechanism. The part that differes is how they get the fluid there but the fluid is the same idea. The idea is that a fluid in the peritoneal cavity will float the structures at risk apart. This is the same. It also explains the very limited efficacy of either product- a main reason why it is not being used widely at all. I am very familiar with both. Thanks for your post but you are mistaken and notr correct. Hyskon (Goodness- I haven’t used that crap since 1994) is actually 32 percent dextran-70. THe complications from Hskon are not due to its mechanism of action. The complications were rare and were mainly allergic. Case reports suggested that Dextran 70 may cause a syndrome resembling disseminated intravascular coagulation — very rare. The allergic response to Hyskon consists of both an anaphylactic and an anaphylactoid component. The pulmonary edema and fluid overload was rare as well. The problem with it was it was like glue when it dried and it simply did not work well at all when tested for adhesion prevention and for hysteroscopy was very limited in what could be done with it vs saline glycine etc. in prospective trials.

Yes, I was not 100% clear when I drew the comparison of the two products. The mechanism of hyskon drawing fluid into the peritoneum and Adept staying put without absorption is “technically different” but THEY BOTH PREVENT ADHESIONS VIA THE SAME MECHANISM - namely the “hydroflotation” mechanism. The part that differes is how they get the fluid there but the fluid is the same idea. The idea is that a fluid in the peritoneal cavity will float the structures at risk apart. This is the same. It also explains the very limited efficacy of either product- a main reason why it is not being used widely at all.

I am very familiar with both.

]]> By: Dextrin not Dextran http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-2475 Dextrin not Dextran Thu, 01 Feb 2007 03:34:56 +0000 http://docinthemachine.com/2006/09/29/fda-approves-adhesion-prevention-solution-for-surgery/#comment-2475 Glad you liked the product. However, your statement, "It works via osmotic gradients to pull water into the pelvic cavity," describes icodexTRAN which is the tradename for Hyskon. This is why there has been multiple complications with the Hyskon product. IcodexTRIN the Tradename for Adept have a completely different mechanism of action of being a slowly absorbed (by the lymphatics) molecule. Average absorbtion time for 1L was shown to be 4-5 days. Glad you liked the product. However, your statement, “It works via osmotic gradients to pull water into the pelvic cavity,” describes icodexTRAN which is the tradename for Hyskon. This is why there has been multiple complications with the Hyskon product.

IcodexTRIN the Tradename for Adept have a completely different mechanism of action of being a slowly absorbed (by the lymphatics) molecule. Average absorbtion time for 1L was shown to be 4-5 days.

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