Friday, January 03, 2014
ADHESIONS AND ADHESIOLYSIS
Really well written paper that is full of hope, current statistics and exciting new areas of research regarding the prevention of adhesions. Happy New Year!
Stephen M. Kavic, MD, Suzanne M. Kavic, MD, Michael S. Kavic, MD
Scar tissue is an expected result of trauma, and this is no less true inside the abdominal cavity as on its surface. Abdominal and pelvic surgical procedures, which are a form of controlled trauma, commonly result in the development of adhesions. Although typically involving the peritoneal surface, adhesions may develop between any 2 surfaces during the healing process. Adhesions may develop between adjacent solid organs, the intestines, fallopian tubes, omentum, or the abdominal wall.
Perhaps due to the lack of effective prevention, adhesions have traditionally received little attention in the literature. However, adhesions are shockingly common after open general and gynecologic procedures. In the largest autopsy series of abdominal adhesions, which included 752 subjects, over 44% had adhesions (67% in patients with prior surgery, and 28% in patients without surgery).1 After multiple laparotomies, the incidence of adhesions may even be as high as 93%.2