Molecular basis of Post-surgical Peritoneal adhesions - An Overview

Post surgical adhesion development remains a frequent occurrence and is often unrecognized by surgeons. Peritoneal adhesions are the leading cause of pelvic pain, bowel obstruction and infertility. The prevention of adhesion till date is speculative due to lack of understanding of mechanisms involved in adhesion development. Adhesions are proposed to the disorder of wound healing and imbalance between fibrinogenesis and fibrinolysis. The unprecedented advancement in Molecular Biology has led us to identify molecules involved in both wound healing and adhesion development. The role of these molecules in peritoneal biological functions is not well understood. Hypoxia is proposed to be major contributing factor for the development of adhesions. The major mechanisms behind adhesion development are increased fibrinogenesis, reduced fibrinolysis, increased Extra Cellular Matrix deposition, increased cytokine production, increased angiogenesis and reduced apoptosis. Better understanding of these events will make efficient management of adhesions possible.