Postoperative adhesions

Postoperative adhesions are fibrous bands that form between tissues and organs, typically as a result of surgical trauma, representing a pathological outcome of the peritoneal wound healing process (StatPearls, 2023). Following injury, a fibrin-rich exudate is deposited; if the fibrinolytic system, primarily driven by tissue plasminogen activator (tPA), fails to degrade this matrix, it becomes a scaffold for fibroblast migration and collagen deposition (PubMed, PMC4229424). This condition is a major cause of adhesive small bowel obstruction, chronic pelvic pain, and female infertility, significantly increasing healthcare costs and surgical complexity (NIH, 2021). While not a single molecular target, the prevention of adhesions involves the use of physical barriers, such as hyaluronic acid-based membranes or icodextrin solutions, which separate serosal surfaces during the critical 3-to-5-day mesothelial regeneration window (PubMed, PMC7351410). Pharmacological research also explores the modulation of inflammatory cytokines and the enhancement of the fibrinolytic cascade to prevent the transition from fibrin to permanent fibrous tissue (StatPearls, 2023).

Other names

Surgical adhesionsPeritoneal adhesionsIntra-abdominal adhesionsPelvic adhesionsAdhesive small bowel obstruction

Prevention of adhesion formation through physical separation of injured tissue surfaces (barrier methods) or modulation of the fibrinolytic/inflammatory cascade to prevent permanent fibrous bridge formation.