SprayShield adhesion barrier system (Covidien Inc.) for prevention of postoperative adhesions
Adhesions are abnormal fibrous bands that form between tissues, organs, and the abdominal wall. Adhesions form due to an abnormal wound-healing process following tissue injury or local inflammation, and they are a frequent sequelae of abdominal or pelvic surgery. Medical conditions such as endometriosis, radiation therapy, pelvic inflammatory disease, and infection can cause inflammation and also promote the formation of adhesions. The incidence of postoperative adhesions ranges from 67% to 98% after general abdominal procedures, and from 60% to 90% after pelvic-gynecological procedures. Patients with adhesions are at a higher risk of subsequent morbidities, including chronic or recurrent pain. Adhesions following gynecologic surgery are a major cause of infertility and chronic pain. Intestinal obstruction is the most serious complication of peritoneal adhesions, and often requires surgical intervention. Given the extent of adhesion-related morbidity, antiadhesion barriers have been developed as adjuncts to meticulous surgical technique to prevent and reduce their occurrence. These barriers, which are solid or fluid, are designed to prevent the formation of fibrin bridges - an early step in adhesiogenesis - by physically separating the traumatized areas from the surrounding tissues.
- Postoperative Complications
- Tissue Adhesions