Pathophysiology of adhesion formation and strategies for prevention.

OBJECTIVE

To review the mechanism of adhesion formation and to briefly discuss the possible sites of action of various preventive measures and adjuvants.

STUDY DESIGN

Literature review.

RESULTS

Although good surgical technique, designed to minimize trauma, is a crucial part of adhesion prevention, technique alone cannot effectively eliminate de novo formation and especially reformation of adhesions.

CONCLUSION

To date, no adjuvant has proven uniformly effective in preventing postoperative adhesions. Nonreactive barriers show promise in selected situations, especially in the presence of apposing, injured peritoneal surfaces. Development of new and more effective compounds and advances in molecular cell biology may provide a more definitive answer to this perplexing problem, which has eluded surgeons for so long.