The prevention of postoperative intra-abdominal adhesion formation with different methods: a review article

Intra-abdominal adhesions are almost inevitable after major abdominal surgery. Postoperative adhesions continue to be the major cause of small bowel obstruction and infertility. Peritoneal lesions caused by abrasion, ischemia, desiccation, infection, thermal injury and foreign bodies are the origin of adhesions. Fibrinous adhesions that develop within a few hours of operational trauma. This fibrin can either re-absorb completely, leaving a clear peritoneal cavity, or become organized by the ingrowth of fibroblasts to form established fibrous adhesions. Adhesions may be diminished in five ways: First, the initial injury can be minimized. Second, the coagulation of exudate can be prevented. Third, prolonged contact of surfaces can be reduced. Fourth, fibrin can be removed after it is formed, and fifth, fibroblast proliferation can be stopped or slowed. Laparoscopic adhesiolysis would be more effective in preventing reformation of adhesions than adhesiolysis with laparotomy. This review include events leading to the formation of adhesions, pathogenesis of adhesions and attempts to prevent adhesions.