Adhäsionen: Fortschritte im Bereich der Adhäsionsprophylaxe und Therapie bei Laparotomie und Laparoskopie

Adhesions are a frequent consequence of methothelial repair at sites traumatised by surgical procedures, such as laparoscopy or laparotomy, where localised hypoxia suppresses fibriolysis enabling fibrin to be deposited between adjacent tissue surfaces. Prevention of peritoneal adhesions at surgical procedures is essential as shown by the clinical consequences of adhesions: chronic abdominal pain, infertility, bowel occlusion and infections. The economic significance of adhesions and their therapy, as evaluated by known adhesion preventive measures, the analysis of a clinical study of a new adhesion prophylaxis and the description of a randomised study illustrate the importance of the prevention of peritoneal adhesions. The application of Ringers lactate does not bring the desired results. Therefore, the use of SprayGel® (Confluent Surgical Inc.) as a barrier substance and the application of Adept® as an instillation medium at the end of the operation are of significance.