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Peritoneal adhesions: Occurrence, prevention and experimental models.
Jingyi Tang1, Ziyin Xiang1, Matthew T Bernards2
1Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China.
Acta Biomaterialia
|September 2, 2020
Summary
Peritoneal adhesions (PA) cause chronic pain and infertility due to disordered coagulation, inflammation, and fibrinolysis. Biomaterial barriers show promise for preventing PA, but challenges remain in their application.
Area of Science:
- Biomedical Engineering
- Regenerative Medicine
- Surgical Complications
Background:
- Peritoneal adhesions (PA) are a common postoperative complication leading to chronic abdominal pain, intestinal obstruction, and infertility.
- PA result from dysregulated blood coagulation, inflammation, and fibrinolysis involving various cell types and signaling molecules (e.g., TNF-α, IL-10, tPA, PAI-1).
Purpose of the Study:
- To review the pathogenesis of peritoneal adhesions.
- To discuss current and emerging treatment strategies for PA prevention.
- To highlight challenges in developing effective biomaterial-based anti-adhesion therapies.
Main Methods:
- Literature review of pathogenesis, treatment approaches, and animal models of peritoneal adhesions.
- Analysis of signaling pathways and cellular mechanisms involved in PA development.
- Evaluation of the efficacy and limitations of existing and novel anti-adhesion strategies.
Main Results:
- PA pathogenesis involves complex interactions between coagulation, inflammation, and fibrinolysis pathways.
- Current anti-PA treatments, including drugs and barriers, have limited widely accepted efficacy.
- Biomaterial-based barriers are a promising approach, but their clinical translation faces significant challenges.
Conclusions:
- Understanding the intricate mechanisms of PA is crucial for developing effective prevention strategies.
- Biomaterial-based barriers represent a promising avenue for PA prevention, requiring further research and development.
- Addressing the challenges in biomaterial design and application is essential for successful clinical implementation in preventing peritoneal adhesions.
