Prevenzione delle aderenze

For a complete text : download Postoperative adhesions and their prevention an article that will be published shortly.

Postoperative adhesions are an important clinical problem

Adhaesions occur in 80% after surgery and are are

a major cause of chronic pain, although pain intensity may be variable

a major cause of infertilty

almost all bowel obstructions are caused by adhesions

Some 30% of women need a reintervention probably because of adhesions within 10 years

Pathophysiology

Our group has been very active in the research of adhesion formation and its prevention. Our major discovery was besides the local trauma, the peritoneal cavity is a major cofactor in adhesion formation. We identified as important factors

the duration of surgery : slow surgeons have more adhesions)
trauma during surgery : less experienced surgeons have more adhesions
dessication of the mesothelial cells
temperature of the pneumoperitoneum
the gaz mixture used for pneumoperitoneum : addition of 4% of oxygen is beneficial.
the amount of bleeding during surgery.

Prevention of adhesion formation

We expect that in a short time surgery, virtually without adhesions will become realistic with what we called combination therapy.