[Prevention of adhesions by intraperitoneal administration of substances in abdominal interventions]

Various substances (saline solution, dextran, heparin, proteinase inhibitors, etc.) have been investigated to determine their influence on adhesion prevention, but until recently the results were controversial and lacked any implication for clinical use. The analysis of intraperitoneal plasminogen activating factor (PAA) and the fibronectin production rate of peritoneal macrophages promises new aspects of adhesion formation and prevention. The results of studies show a close correlation between ischemia/infection and the decrease of PAA as well as increased adhesion formation in patients (endometriosis) with increased fibronectin production by peritoneal macrophages.