Peritoneal adhesions: facing the enemy.

Background: Postsurgical adhesions severely affect the quality of life of millions of people worldwide. Numerous attempts have been made to prevent or reduce the incidence of peritoneal adhesions, but with limited success.

Data Sources: An extensive Medline search, textbooks, scientific reports and scientific journals are the data sources. We also reviewed reference lists in all articles retrieved in the search as well as those of major texts regarding postsurgical intraperitoneal adhesion formation.

Conclusions: A multifactorial approach including minimizing tissue injury, prophylactic antibiotic usage to reduce infectious morbidity, and biochemical agents with or without biomechanical barriers will reduce the amount and severity of adhesions. However, further research is needed to establish the safety, effectiveness and also the cost/benefit ratio of these substances in human subjects.