Page 63 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Postoperative adhesion prevention with a new barrier
Fig. 4. Experiment 2. PVA/CMC compared to icodextrin 4%, control group: histological examination of the abdominal wall after 2 weeks. A new mesothelial layer is visible on the abdominal side (black arrows).
Discussion
Postoperative adhesion formation is the result of disturbed healing of the peritoneum after surgical trauma, infection or ischemia. Hereby an inflammatory reaction is induced, resulting in migration of neutrophils, macrophages and leucocytes to the site of the trauma. In combination with simultaneous activation of resident mesothelial cells, which produce cellular mediators encouraging the migration process, a fibrinous exudate is formed. Whether this exudate will lead to adhesion formation depends on the fibrinolytic capacity in the peritoneal cavity [15, 16]. Severity and extent of surgical trauma are important factors influencing this formation.
In addition to surgical trauma caused by instruments, Luijendijk et al found that foreign materials such as glove powder and sutures also
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