Medical technical product, method for producing the same and providing the same for surgery
A medicotechnical product for adhesion prophylaxis for the post-operative prevention of accretions in the body comprises at least one PVA (polyvinyl alcohol) selected from the group comprising uncrosslinked PVA with a molecular weight of 15,000 to 400,000, crosslinked PVA and mixtures thereof. The molecular weight of the PVA or the mixture is selected in such a way that it can be excreted via the kidneys substantially with no degradation of the PVA molecules.
1 - 47 . (canceled)
48 . Method for prophylaxis of adhesions in surgery in human and veterinary medicine comprising administering a medicotechnical product comprising at least one PVA (polyvinyl alcohol) selected from the group consisting of uncrosslinked PVA with a molecular weight of 15,000 to 400,000, physically crosslinked PVA with a molecular weight of 15,000 to 400,000, and mixtures thereof and wherein the physical crosslinking is performed by freezing/thawing cycles.
49 . The method according to claim 48 , wherein the PVA has a molecular weight of 20,000 to 400,000 g/mole.
50 . The method according to claim 48 , wherein the PVA is formed from a mixture of low and high molecular weight components, and wherein at least one is high molecular weight PVA.
51 . The method according to claim 48 , wherein the PVA with a molecular weight of 15,000 to 400,000 is chemically crosslinked.
52 . The method according to claim 51 , wherein the chemical crosslinking is performed by crosslinking esterification.
53 . The method according to claim 51 , wherein the chemical crosslinking is carried out using crosslinking agents, which give a crosslinking reversible in vivo.
54 . The method according to claim 53 , wherein the chemical crosslinking agents, which give a crosslinking reversible by chemical hydrolysis.
55 . The method according to claim 48 , wherein the crosslinking agents are polyvalent carboxylic acids and/or their derivatives.
56 . The method according to claim 48 , wherein the PVA with a molecular weight of 15,000 to 400,000 is physically crosslinked.
57 . The method according to claim 56 , wherein the physical crosslinking is performed by crystallite formation.
58 . The method according to claim 48 , wherein the PVA is modified by radicals bound via hydroxyl groups.
59 . The method according to claim 58 , wherein 1 to 10 radicals are present per PVA molecule.
60 . The method according to claim 59 , wherein 1 to 2 radicals are present per PVA molecule.
61 . The method according to claim 58 , wherein the C 2 to C 16 radicals contain carbon atoms and are carbohydrate, fatty acid and/or alcohol radicals.
62 . The method according to claim 48 , wherein PVA is mixed with a high molecular weight component, which is not PVA.
63 . The method according to claim 62 , wherein in that the high molecular weight component is present in a quantity of 0.5 to 4 wt %.
64 . The method according to claim 63 , wherein in that the high molecular weight component is present in a quantity of 1 to 2 wt %.
65 . The method according to claim 62 , wherein a sugar polymer is added as the high molecular weight component to the PVA.
66 . The method according to claim 65 , wherein the sugar polymer is selected from the group consisting of carboxymethyl cellulose, dextran, hydroxymethyl cellulose, and mixtures thereof.
67 . The method according to claim 48 , wherein the product is in the form of an at least one-layer film.
68 . The method according to claim 67 , wherein the film is in the form of a bilayer or trilayer of PVA and carboxymethyl cellulose.
69 . The method according to claim 67 , wherein the film has a structuring on at least one side.
70 . The method according claim 67 , wherein there is at least one layer in the form of a foam or a foam precursor.
71 . The method according to claim 48 , wherein it is in the form of a solution.
72 . The method according to claim 48 , wherein it is in the form of a member of the group consisting of a gel and a microgel.
73 . The method according to claim 72 , wherein it is in the form of a dimensionally stable hydrogel.
74 . The method according to claim 48 , wherein it is the form of a member of the group consisting of microparticles and nanoparticles.
75 . The method according to claim 48 , wherein it is in a form swollen with aqueous media.
76 . The method according to claim 75 , wherein a liquid quantity of up to 20% of the product weight is absorbed by swelling in a dry membrane.
77 . The method according to claim 48 , wherein the molecular weight of the PVA or the mixture is chosen in such a way that optionally following a hydrolysis or the elimination of the crosslinking, the PVA molecules are excreted via the kidneys, substantially without degradation.
78 . The method according to claim 48 , wherein the product has a functioning period in the operating region is 5 to 21 days.
79 . The method according to claim 78 , wherein the product has a functioning period in the operating region is 5 to 14 days.
80 . The method according to claim 48 , wherein the product macroscopic dissolving under physiological conditions is 7 to 60 days.
81 . The method according to claim 48 , wherein the product is excreted via the kidneys substantially without degradation of the PVA molecules.
82 . The method according to claim 81 , wherein the product is lyophilized.
83 . The method according to claim 81 , wherein the physical crosslinking is carried out by freezing-thawing cycles, which are repeated several times.
84 . The method according to 83 , wherein nanoparticles are produced by freezing-thawing cycles.
85 . The method according to claim 48 , wherein PVA is chemically crosslinked in a solvent mixture, a crosslinking reversible under physiological conditions being preferred.
86 . The method according to claim 85 , wherein PVA is reversibly chemically crosslinked.
87 . The method according to claim 86 , wherein the crosslinking agent is a member selected from the group consisting of polyvalent carboxylic acids, and Derivatives thereof.