Natural course of postsurgical adhesions

To evaluate the natural course of postsurgical adhesion formation, a descriptive animal study was performed in a standardized rat adhesion model, involving the uterine horn and peritoneal side wall. Extent and type of postsurgical adhesion formation was evaluated at increasing postoperative time intervals up to 1 year, both through inter- and intra-animal observations (laparotomy and repeated-laparotomy group). The extent of the adhesions was found to be similar while the type of the adhesions changed markedly, especially during the early observation periods. From day 1 until 1 month post- operatively, the adhesions became increasingly more organized and vascular and were separable with sharp dissection only. From the present study it was concluded that spontaneous lysis of postsurgical adhesions, once they are established, does not seem to occur. The most optimum time for surgical intervention when scheduled to lyse newly formed adhesions will be between 8 days and 1 month after the initial procedure.