Postsurgical Adhesions: Is There Any Prophylactic Strategy Really Working?

Flutur, Irina-Maria; Păduraru, Dan Nicolae; Bolocan, Alexandra; Palcău, Alexandru Cosmin; Ion, Daniel; Andronic, Octavian

doi:10.3390/jcm12123931

Cited by 5 publications

(1 citation statement)

References 82 publications

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“…Although most adhesions are asymptomatic, they represent a significant social burden of disease. This is partly due to the fact that half of the total population will undergo abdominal surgery during their lifetime [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Immunostimulation for Postoperative Intra-Abdominary Adhesion in an Experimental Rat Model

Puchkina,

Bondarenko,

Mikhaylichenko

et al. 2023

ArveMED

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Purpose of the Study: To analyze the effectiveness of using sodium deoxyribonucleate (SDN) for pelvic adhesions in rats in experiment. Materials and Methods: The experiment was carried out on 90 laboratory rats. Three groups of 30 animals each were formed: group 1 – control; group 2 – rats with a simulated adhesive process in the pelvis without subsequent treatment; group 3 – animals with a model of adhesive process in the pelvis receiving intramuscular SDN for 10 days. The adhesive process in the pelvis was modeled in rats by ligating the uterine horns on both sides. The expression of CD4, CD8, CD20, CD138 was studied using DP-SOFT software program and subsequent statistical processing. Results: In animals of the control group, a small number of cells with expression of CD4+, CD8+ and CD138 markers were found in the parietal peritoneum (PP). In perimetrium (PM), no positively stained cells of the studied immunophenotype were found. In group 2, animals showed an increase in the number of cells in the PP positively expressing CD4+ and CD138+, and the appearance of CD56+ cells. An increase in the number of CD138+ and CD4+ cells was found in the rats’ PM. In group 3, compared to the control, the count of CD4+ cells, CD56+ cells and CD138+ cells significantly increased. In the PM of the operated animals, we found an increase in the number of cells positively expressing CD4+ and CD138+, and the appearance of CD56+ cells. In the PM of rats, an increase in the number of CD138+ and CD4+ cells was noted, which indicates activation of the humoral immune system. In group 3, the count of CD4+, CD56+ and CD138+ – cells in the PP significantly increased compared to the control. PM was characterized by a similar distribution of cells. Conclusion: After surgery, the adhesive process causes a change in the ratio of leukocyte subpopulations in the affected area towards an increase in their number in the parietal peritoneum rather than in the perimetrium. The use of SDN has an immunomodulatory effect and stimulates immune responses by increasing the number of immunocompetent cells in the surgical site.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of Immunostimulation for Postoperative Intra-Abdominary Adhesion in an Experimental Rat Model

Puchkina,

Bondarenko,

Mikhaylichenko

et al. 2023

ArveMED

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Bi-layered polyurethane nanofiber patches with asymmetrical surface prevent postoperative adhesion and enhance cardiac repair

Li,

Ahmed,

Wang

et al. 2024

Composites Part B: Engineering

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What Should I Use? Impact of Adhesion Barriers on Postoperative Abdominal Complications: A Systematic Review

Maheta,

Manhas,

Niu

et al. 2024

The American Surgeon™

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Background Adhesions are a feared complication of abdominal surgery. There have been many new adhesion barriers developed and tested; however, there is no recent systematic review analyzing all the published literature. To address this, we aimed to analyze the different types of adhesion barriers, and determine their effects on postoperative outcomes in patients. Methods A total of 14,038 articles utilizing adhesion barriers in abdominal surgery were retrieved from the PubMed, EMBASE, and Scopus databases. Inclusion criteria were: patients undergoing abdominal surgery, patients receiving an adhesion barrier, and reported postoperative outcomes. Two reviewers independently screened titles/abstracts and full-text articles using Covidence. The ROBINS-I tool was used to assess the quality of the included studies. Study protocol: Prospero CRD42023458230. Results A total of 20 studies, with no overall high risk of bias, with 171,792 patients were included. Most studies showed an equivocal benefit for adhesion barriers, with no singular adhesion barrier type that had definitive superior outcomes compared to the others. Bioresorbable barriers emerged as the most extensively researched adhesion barrier type, exhibiting promising results in colorectal surgery. Starch-based adhesion barriers also exhibited a reduction in overall postoperative bowel obstructions and may be beneficial for stoma sites and port closures. On the other hand, many studies raised concerns regarding complications, including risk of abscess formation, fistula development, peritonitis, and anastomotic leakage. Conclusions Adhesion barriers should be considered on a case-by-case basis, however, they should not be utilized prophylactically in all abdominal surgeries due to their risk of complications.

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Postsurgical Adhesions: Is There Any Prophylactic Strategy Really Working?

Cited by 5 publications

References 82 publications

Effectiveness of Immunostimulation for Postoperative Intra-Abdominary Adhesion in an Experimental Rat Model

Effectiveness of Immunostimulation for Postoperative Intra-Abdominary Adhesion in an Experimental Rat Model

Bi-layered polyurethane nanofiber patches with asymmetrical surface prevent postoperative adhesion and enhance cardiac repair

What Should I Use? Impact of Adhesion Barriers on Postoperative Abdominal Complications: A Systematic Review

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