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Chống sẹo gây tê ngoài màng cứng

Adcon-L là một ma trận gel có khả năng phân huỷ sinh học gần đây đã được chấp thuận của Cục Quản lý Thuốc và Thực phẩm để sử dụng trong đơn cấp laminectomy sau thắt lưng hoặc các thủ tục laminotomy. Nghiên cứu thực nghiệm và lâm sàng đã cho thấy rằng việc sử dụng | Perspectives on Modern Orthopaedics Use of Adcon-L for Epidural Scar Prevention Jeffrey S. Fischgrund MD Abstract Adcon-L is a biodegradable gel matrix that was recently approved by the Food and Drug Administration for use during single-level posterior lumbar laminectomy or laminotomy procedures. Experimental and clinical studies have suggested that the use of this product will decrease postoperative epidural scarring. However the relationship between epidural fibrosis and patient outcome remains unclear. If the treating surgeon is of the opinion that there is a need to reduce epidural scar the use of this product appears worthwhile. However further studies are needed to evaluate clinical outcome and justify the use of this product on a routine basis. J Am Acad Orthop Surg 2000 8 339-343 Adcon-L Gliatech Inc Cleveland Ohio is a sterile absorbable gel matrix composed of a gelatin in a carbohydrate polymer. The material is biodegradable does not incite any inflammatory reaction and is reported to disappear completely within 21 days after implantation. Animal studies have shown that Adcon-L or its prototypes can reduce the development of fibrotic epidural scars in rat rabbit and dog laminectomy models.1 2 On the basis of subsequent studies in dog laminectomy and diskectomy models as well as a large prospective multicenter randomized trial performed in Europe 3 the US Food and Drug Administration FDA recently approved Adcon-L as a device rather than as a drug for marketing in the United States. Since receiving approval in May 1998 Gliatech has been marketing Adcon-L with the following FDA-approved wording on its label 1 Adcon-L significantly reduces postsurgical scarring and adhesions. 2 Adcon-L improves pa tient outcome and reduces activity-related pain as compared to the control group. 3 Adcon-L has no significant adverse events attributed to its use. Epidural Fibrosis With proper patient selection more than 90 of patients who undergo surgical treatment for lumbar .