Elizondo-Hinojosa JL, López-Gutiérrez J, Poblano-Morales M, Yañes-López J, Pérez-García R

Language: Spanish
References: 28
Page: 36-42
PDF size: 855.79 Kb.

ABSTRACT

The postoperative abdominal adhesions are the more frequent cause of intestinal occlusion with major complications, besides to produce infertility and chronic pelvic pain. Their formation and develop are linked to the peritoneal physiology in the repair of surface defects, infections, ischaemia, inflammation, hemorrhage and chemical irritation. The peritoneal repair is an entire series of events with the participation of inflammatory response, the formation of serofibrinous exudates and the fibrin gel matrix. In all of these processes participate several substances and chemical mediators, principally the plasminogen tissular activator. The two more important events in the formation of adhesions are: 1) The coaptation of the two damaged mesothelial surfaces and 2) the imbalance between fibrin deposits and its dissolution. Several methods of prevention in the posoperative adhesions formation are divided in: 1. Limit or prevent the damage to the serous peritoneum, 2. Diminish the inflammatory response, 3. Remove, dissolve or separate the fibrin gel matrix from the peritoneal surfaces, and 4. Inhibit the fibroblastic proliferation. In each of these different points have been used procedures, barriers and drugs which show several effectiveness degrees, side effects and limitations. There are some research lines to inhibit the formation of postoperative adhesions.

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