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Breaking the Surgical Adhesion Barrier

This article was originally published in Start Up

Executive Summary

Post-surgical adhesions occur almost any time a surgeon opens up a body cavity; in intra-abdominal surgery, for example, they form 85-90% of the time. But after a decade of trying, the medical device industry has only two adhesion prevention products to show for its efforts, and both products have drawbacks that have limited their market penetration. A new generation of companies--Confluent Surgical, Angiotech Pharmaceuticals, FzioMed, Sentrx Surgical, Afmedica, Kytogenics Pharmaceuticals, and ARC Pharmaceuticals, hope to profit from years of learning in the field to get new and improved products into the hands of surgeons .

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Cohera Medical Inc.

The lead product from Cohera Medical platform technology is a sprayable adhesive strong enough to hold tissue layers together following surgery. TissuGlu is an absorbable, urethane adhesive that is non-toxic for use inside the body. The initial indication will be plastic surgery, with an emphasis on abdominoplasty (tummy tuck). For such a procedure, the product is sprayed in between two flaps of tissue for reattachment, thus preventing fluid buildup that would otherwise occur between unattached layers of tissue and require cumbersome post-surgical drains with their associated complications.

3DM Inc.

The field of tissue engineering has long sought a synthetic version of the extracellular matrix and 3DM Inc. may just have found the ideal synthetic nano-scaffold to fill the void. The company's founders-many of whom come from the Massachusetts Institute of Technology (MIT)-make up a "Who's Who" of biomaterials and tissue engineering.

Afmedica Inc.

It's not much of a stretch for companies to apply to other surgical markets the concepts that made drug-eluting stents such an overnight success. The overhealing response that characterizes in-stent restenosis is at the heart of many other processes that limit the long-term success of surgical interventions. In fact, Afmedica Inc. is building a drug plus device platform for vascular surgery around sirolimus, the very same drug that enabled Johnson & Johnson to be the first company to demonstrate that its drug-eluting stent prevents restenosis. Afmedica has built an IP estate around the use of the drug on the outside of vessels, where, in combination with non-inflammatory polymers, it might help reduce the failure of vascular access grafts for dialysis, prevent the closure of peripheral bypass grafts, and prevent surgical adhesions in abdominal surgery.


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