An adhesion is a band of scar tissue that binds together anatomic surfaces which are normally separated from each other.
Given a tissue injury, Macrophages forms the As the adhesion The existing the healing process basis of adhesion and develops, blood adhesions develops, takes place in a closely fiblin matrix develops, vessels increase and so the distinction orchestrated cascade to leading to multiplying structurally organize. from the tissue repair the damage fibroblasts and becomes unclear and : macrophages, angiogenesis begins. forms dense bands. fibroblasts, fibrin matrix etc.
3 /18 Function of Anti-adhesion
When anti-adhesion Most of the cells that Mesothelial cell has A layer rich in barrier is placed cover the wound tissue been shown to play a Mesothelial Cells between the surface are role in anti-adhesion forms a natural anti- wounded tissue macrophages. adhesion surface surfaces, it acts as a Mesothelial Cells do not and prevents the physical barrier, yet exist on the wound formation of new preventing adhesion surface. adhesions. formation during the healing of the wound.
4 /18 Characteristics
Hibarry which developed its
own technology in Korea provide optimum anti-adhesion effect.
Storage At room temperature(1~30°C), Protect from light, Protect from freezing
Shelf life 2 years from date of manufacture
Purpose of use As a deep cavity wound dressing, Primarily reducing adhesion during spinal surgery
Package 1.5 mL / 3.0 mL / 5.0 mL / 10.0 mL per prefilled Syr.
5 /18 Characteristics of components
COOH CH2OH O O
O O OH OH OH NHAc
• Only HA (Hyaluronic acid : HA): Components in vivo.
• Because of using the Cross-linked Hyaluronic acid, maintenance a certain period in the body. 6 /18 Characteristics of Hibarry
Pure Hyaluronic acid
Excellent biocompatibility and biodegradability
Other Hibarry Cross-linked Hyaluronic acid Appropriate anti-adhesion retention time • Using the Cross-linked Hyaluronic acid : Maintenance a certain period in the body. High viscosity ·High molecular weight • Using the high molecular weight and high viscosity Flow prevention when applied & catch the target correctly undiluted solution : Optimal role of physical barriers
▪ The adhesion process prevented clearly by BNCH-202 ▪ Journal of Veterinary Clinics (Vol. 28. No.1)
11 /18 The Synopsis of Clinical Study
▪ Title A clinical study to evaluate the efficacy and safety of BNCH-202 for prevention of adhesion after spinal surgery
▪ Methods Controlled, Multicenter, Single-blind
▪ Institutes Yonsei University Catholic Medical University Gacheon Medical University Korea University
▪ Sample size (76 people)
Control group 38 people, Test group 38 people
12 /18 Certification
13 /18 Application Fields
Neuro surgery Spine-related surgery / Larminectomy & Discectomy
General surgery Thyroid surgery / Breast-related surgery
Plastic surgery Hand, foot micro-surgery / Tissue reconstructive surgery
Orthopedic surgery Spine-related surgery / Hand, foot, shoulder and trauma disease surgery
Endoscopic and open surgery of the Uterus and attached to the uterine Obstetrics & Gynecology disease / Cesarean/ Curettage (Incomplete missed abortion)
Urology Incision of prostate / Urinary tract surgery / Urethral stricture repair
14 /18 Application Fields
Thesis Title Anti-adhesion barrier reduces adhesions after laparoscopic surgery for adhesiolysis
Journal Fertility and Sterility® Vol.88, No. 5, November 2007
Design A double-blind, randomized, controlled study, conducted at 16 referral centers.
402 Patients returned for second laparoscopy within 4~8 weeks Patients Adept(n=203) LRS(n=199) LRS stands for lactated Ringer’s solution At first laparoscopy, 100ml irrigant every 30mins during surgery 1 liter instilled at the end of surgery Method After 28 to 56 days later, 2ND laparoscopy for assessment
Results * adhesion reduction – Adept 49%, LRS 38%
* reduction in AFS score among infertility patients – Adept 53%, LRS 30% AFS score stands for American Fertility Society Efficacy * free of de novo adhesion – Adept 53%, LRS 43% * the mean reduction in incidence of adhesions with Adept was 4.38+-3.70 versus 2.95=-3.35 for LRS patients
Safety * Adverse events occurred in 19 patients(8 Adept patients, 25 event; 11 LRS patients, 19 events) This study demonstrated that use of Adept as an irrigant and postoperative instillate reduces adhesions aft Discussion er laparoscopic gynecologic adhesiolysis.
15 /18 Application Fields
Thesis Title Anti-adhesive effect of Anti adhesion barrier after Endoscopic sinus surgery
Journal Korean J Otolaryngology 2005;48:1478-83
Design Randomized and double blinded
Patients 44 patients (experimental group, Anti adhesion barrier applied on Merocel®, n=22) (control group, NS applied on Merocel®, n=22)
Method At the end of endoscopic sinus surgery, 6ml Anti adhesion barrier was applied on Merocel® and repeatedly applied on the middle meatus after removal of Merocel As a control group normal saline was allied instead of Anti adhesion barrier
Results The groups with the Anti adhesion barrier treatment showed lower adhesion formation than the Efficacy control
Safety The safety profile of the patients was normal at 4 weeks postoperatively
Anti adhesion barrier may be an efficacious and safe material in decreasing the incidence of adhesion after Conclusions sinus surgery
16 /18 Application Fields
Thesis Title Efficacy of anti-adhesive barriers in secondary thyroidectomy : An Experimental study
Journal Laryngoscope, 114:1668-1673, 2004
Design Controlled, randomized study
Patients 28 male Wistar Albino rats that underwent right subtotal thyroidectomy were assigned Group 1:Seprafilm(n=10), group 2:Interceed(n=10) and group 3:the control group(n=8)
Method After surgery, .5* .5 cm sheet of seprafilm and interceed were inserted between the trachea and the muscles And the control group are not given any substance After 14 days, surgical fields were evaluated for the adhesion formation.
Results Control group: all surgical fields needed to be dissected with instruments Seprafilm group: 6 of 10 subjects had no adhesions Efficacy 4 out of 10 needed dissection Interceed group: 3 of 10 subjects had no adhesions. 6 out of 7 needed blunt, 1 of 7 needed sharp dissection Safety - Seprafilm® and Interceed® were found to be effective in preventing adhesions in re-operative thyroid surgery in Conclusions an animal model
