Combined Hemostasis and Adhesion Prevention with the Novel Agent 4DryField ® PH—Initial Observations

Large size peritoneal trauma from extended surgery for high-grade expansive uterus pathology or endometriosis might result in severe diffuse bleeding and peritoneal adhesion formation with ob-jectionable sequelae. This paper introduces 4DryField ® PH polysaccharide powder certified for two indications: 1) given as powder 4DryField ® PH provides hemostasis; 2) transformed into gel, 4DryField ® PH forms an adhesion prevention barrier. Twenty-one women with expanded uterus pathology and/or deep infiltrating endometriosis had surgery including repair of intestine lesions (n = 8), ureterolysis/repair of bladder, including retrograde ureteric stents (n = 5). Subjective im-pression of hemostatic effect, drain loss and infection parameters were recorded. Six women had scheduled second look laparoscopy. 4DryField ® PH applied as powder showed an immediate sig-nificant hemostatic effect in all instances, especially in profound diffuse bleeding. Mean drain loss was 497 ± 339 mL, moderate considering the extent of disease. Dripped with saline solution, 4Dry Field ® PH immediately formed a viscous gel acting as a barrier for adhesion prevention. Second look laparoscopy revealed only one patient with significant adhesions. No adverse events were observed; discharge was at Day 6.2 ± 1.4. In this cohort with extended gynecological laparoscopic