Postoperative abdominal adhesions: pathogenesis and current preventive techniques

Post-operative abdominal adhesions (PAA) are a condition that occurs in more than 90% of patients undergoing abdomen surgery; they can cause chronic abdominal pain, female infertility and repeated bowel obstruction, requiring repetitive surgical interventions causing morbidity and mortality, as well as high costs. The formation of the PAA is due to an imbalance between the fibrinogenesis and fibrinolysis in favor of the first, associated with tissue hypoxia secondary to aggression of the peritoneum, also due to the own inflammatory response and the increase in the population of adhesion fibroblasts which inhibit the degradation of the extracellular matrix and facilitate mature collagen and supporting connective tissue. The prevention of PAA will decrease secondary complications, as well as hospitalizations, surgeries and consequently, cost containment. The PAA pathophysiologic process allows establishing research strategies in order to prevent them.