Are skin scar characteristics associated with the degree of pelvic adhesions at laparoscopy?

Objective: To investigate whether individual or a combination of abdominal surgical scar characteristics can predict the severity and extent of intra-abdominal adhesions.

Design: A prospective cohort study.

Setting: A tertiary referral center in the United Kingdom.

Patient(s): One hundred women who had previously undergone abdominopelvic surgery and were undergoing an elective laparoscopic gynecologic operations.

Intervention(s): Abdominal scars were evaluated preoperatively using the modified Manchester Scar Questionnaire Adhesions were assessed intraoperatively and compared with the cutaneous findings.

Main Outcome Measure(s): Presence and severity of intra-abdominal adhesions.

Result(s): Of 100 women recruited into this study, 71 (71%) women were found to have intra-abdominal Aadhesions, and 29 (29%) had no adhesions. Women who had more than one abdominal scar, a palpable scar, and/or a longer scar were most likely to have pelvic adhesions during the current surgery. Women with the highest mean scar scores also had a greater total adhesion score.

Conclusion(s): Adhesions are a common postoperative consequence of open or laparoscopic surgery. Skin scar characteristics are associated with the presence and degree of pelvic adhesions. Future studies should examine whether these characteristics can be used as a preoperative predictive tool to facilitate surgical decision-making and elective operating room organization.