Prevention

Always talk to your doctor about adhesions, their complications and preventative measures you can consider before abdominal or pelvic surgery.

Prevention of adhesions is a better alternative than treating complications later caused by them. The only way to treat adhesions, is to surgically remove them during a procedure called adhesiolysis. Adhesiolysis separates or removes adhesions from the internal organs. Ironically, since the procedure itself damages the peritoneum, it can cause even more adhesions whilst you recover from it. Adhesions can also reform in the same regions after adhesiolysis has removed them.

Surgeons do all they can to prevent or reduce the occurrence of post-surgical adhesions by:

• minimising bleeding
• using adhesion prevention products
• maintaining moisture level of tissues
• carefully closing the peritoneum
• using appropriate implants and sutures
• administering medications to reduce inflammation and
• gently handling organs and tissues - limiting injury to the peritoneum.

Refer to the section Talking to your doctor to help you plan and to discuss possible adhesion prevention strategies.

TYPES OF PREVENTION AVAILABLE

Drug interventions have been trialled but have limited effectiveness at preventing the formation of adhesions. Doctors strive to use the latest, least damaging surgical techniques to prevent and reduce adhesion formation, but a clinical need remains to reduce the risk of adhesions forming.

Barrier adhesion prevention products are currently the most useful adjuncts to reducing adhesion formation. Barrier products effectively separate the traumatised peritoneal surfaces from each other during the critical healing period during which adhesions are most likely to form, 5-7 days after surgery.1

Barriers are classified into solution (liquid) barriers and solid barriers.

SOLUTION (LIQUID) BARRIERS

When liquid barrier adhesion prevention is used, medically prepared and tested fluid is placed in the peritoneal cavity following a surgical procedure. This fluid allows the natural healing process to take place whilst also allowing the organs to be suspended and not rub against each other as much as they would otherwise. The liquid provides a physical barrier, reducing the rate at which damaged peritoneal surfaces form adhesions with the surfaces of other tissues and organs close to them.

SOLID BARRIERS

Solid barrier adhesion prevention products have been in use for many years. Some are film-like and others are guaze-like materials – usually prepared in sheets. After completion of the surgical procedure, but before the external surgical wound is closed, a barrier sheet can be wrapped or stitched around an organ that has been operated on to cover the suture line. The sheets become gel-like and are slowly reabsorbed into the body overtime.