Current Strategies and Future Perspectives for Intraperitoneal Adhesion Prevention

Introduction The formation of peritoneal adhesions still is a relevant clinical problem after abdominal surgery. Until today, the most important clinical strategies for adhesion prevention are accurate surgical technique and the physical separation of traumatized serosal areas. Despite a variety of...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2012-06, Vol.16 (6), p.1256-1274
Main Authors: Brochhausen, Christoph, Schmitt, Volker H., Planck, Constanze N. E., Rajab, Taufiek K., Hollemann, David, Tapprich, Christine, Krämer, Bernhard, Wallwiener, Christian, Hierlemann, Helmut, Zehbe, Rolf, Planck, Heinrich, Kirkpatrick, C. James
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Adhesion
Biomedical materials
Clinical medicine
Cytokines
Digestive System Surgical Procedures - methods
Digestive System Surgical Procedures - standards
Gastroenterology
Humans
Inflammation
Medicine
Medicine & Public Health
Minimally Invasive Surgical Procedures - standards
Morphology
Pathophysiology
Peritoneal Diseases - etiology
Peritoneal Diseases - pathology
Peritoneal Diseases - prevention & control
Peritoneum - pathology
Physiology
Practice Guidelines as Topic
Prevention
Review Article
Surgery
Tissue Adhesions
Wound healing
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Summary:Introduction The formation of peritoneal adhesions still is a relevant clinical problem after abdominal surgery. Until today, the most important clinical strategies for adhesion prevention are accurate surgical technique and the physical separation of traumatized serosal areas. Despite a variety of barriers which are available in clinical use, the optimal material has not yet been found. Discussion Mesothelial cells play a crucial physiological role in frictionless gliding of the serosa and the maintenance of an antiadhesive surface. The formation of postoperative adhesions results from a cascade of events and is regulated by various cellular and humoral factors. Therefore, optimization or functionalization of barrier materials by developments interacting with this cascade on a structural or pharmacological level could give an innovative input for future strategies in peritoneal adhesion prevention. For this purpose, the proper understanding of the formal pathogenesis of adhesion formation is essential. Based on the physiology of the serosa and the pathophysiology of adhesion formation, the available barriers in current clinical practice as well as new innovations are discussed in the present review.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-011-1819-9