Adhesions
From Ganfyd
A consequence of inflammation and fibrosis. Anatomically distinct areas may become stuck together. This can occur anywhere, but it is common intra-peritoneally, either due to inflammatory conditions or from the surgery itself.
Abdominal adhesions are a common cause of small bowel obstruction.[1]
The pathogenesis is complex as it involves interactions between the inflammatory response, clotting cascade, wound healing and mesothelial cells.
Contents |
Prevention
Technique
- Avoid powdered gloves.
- Minimise tissue handling, dissection and trauma.
Pharmacological
- Fibrinolytics
- Fluids and gels
- Icodextrin solution (Adept®)
- Intergel®
- Spraygel®
- Barriers
This article is a work in progress. Please feel free to contribute to it.
References
- ↑ Boland GM, Weigel RJ. Formation and prevention of postoperative abdominal adhesions. The Journal of surgical research. 2006 May; 132(1):3-12.(Link to article – subscription may be required.)
- ↑ Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, Wolff BG, Roberts PL, Smith LE, Sweeney SA, Moore M. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg. 1996 Oct;183(4):297-306.
- ↑ Vrijland WW, Tseng LN, Eijkman HJ, Hop WC, Jakimowicz JJ, Leguit P, Stassen LP, Swank DJ, Haverlag R, Bonjer HJ, Jeekel H. Fewer intraperitoneal adhesions with use of hyaluronic acid-carboxymethylcellulose membrane: a randomized clinical trial. Ann Surg. 2002 Feb;235(2):193-9. (Direct link)
