Will there be progress?


DOI of original article: 10.1016/j.jss.2012.0 * Corresponding author. 41 Brownstone Way E-mail address: abarbul009@gmail.com. 0022-4804/$ e see front matter a 2013 Elsev http://dx.doi.org/10.1016/j.jss.2012.10.006 Intra-abdominal adhesions represent a major problem. Intestinal obstruction, infertility, and pain are just the most common complications of adhesion formation, often necessitating surgical correction, with its attendant morbidity and costs. In the past two decades our understanding of the pathophysiology of adhesion formation has greatly increased. At its most basic, adhesions represent a healing response following mesothelial (e.g., peritoneal and pericardial) injury, most often secondary to surgical procedures. This response follows almost all abdominal procedures, but many adhesions undergo involution and resolution. The persistent adhesions undergo organization and fibrosis, leading to the dense, vascularized, and scarred appearance of clinically relevant adhesions [1]. We further understand that meticulous and gentle surgical technique, use of ligatures that are size-appropriate and take minimal tissue, maintenance of moist environment, avoidance of foreign or particulate matter (for example, starch on gloves), precise hemostasis, and maintenance of a sterile environment are all measures that have become enshrined as part of modern surgical care. Laparoscopic surgery appears to reduce the incidence of adhesion formation, probably because

DOI: 10.1016/j.jss.2012.10.006

Cite this paper

@article{Barbul2013WillTB, title={Will there be progress?}, author={Adrian Barbul}, journal={The Journal of surgical research}, year={2013}, volume={185 2}, pages={518-9} }