Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions
Abstract Postsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti‐inflammatory...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Bioengineering & Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/btm2.10565 |
| _version_ | 1797556857626165248 |
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| author | Jiahui Chen Xiaoqi Tang Ziyu Wang Arielle Perez Benjamin Yao Ke Huang Yang Zhang Martin W. King |
| author_facet | Jiahui Chen Xiaoqi Tang Ziyu Wang Arielle Perez Benjamin Yao Ke Huang Yang Zhang Martin W. King |
| author_sort | Jiahui Chen |
| collection | DOAJ |
| description | Abstract Postsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti‐inflammatory and fibrinolytic agents. The Food and Drug Administration (FDA) has approved the use of physical barrier agents, but they have been associated with conflicting clinical studies and controversy in the clinical utilization of anti‐adhesion barriers. In this review, we summarize the human anatomy of the peritoneum, the pathophysiology of adhesion formation, the current prevention agents, as well as the current research progress on adhesion prevention. The early cellular events starting with injured mesothelial cells and incorporating macrophage response have recently been found to be associated with adhesion formation. This may provide the key component for developing future adhesion prevention methods. The current use of physical barriers to separate tissues, such as Seprafilm®, composed of hyaluronic acid and carboxymethylcellulose, can only reduce the risk of adhesion formation at the end stage. Other anti‐inflammatory or fibrinolytic agents for preventing adhesions have only been studied within the context of current research models, which is limited by the lack of in‐vitro model systems as well as in‐depth study of in‐vivo models to evaluate the efficiency of anti‐adhesion agents. In addition, we explore emerging therapies, such as gene therapy and stem cell‐based approaches, that may offer new strategies for preventing adhesion formation. In conclusion, anti‐adhesion agents represent a promising approach for reducing the burden of adhesion‐related complications in surgical patients. Further research is needed to optimize their use and develop new therapies for this challenging clinical problem. |
| first_indexed | 2024-03-10T17:08:54Z |
| format | Article |
| id | doaj.art-8509d9f6c2294f2faabbbae23658dc91 |
| institution | Directory Open Access Journal |
| issn | 2380-6761 |
| language | English |
| last_indexed | 2024-03-10T17:08:54Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Bioengineering & Translational Medicine |
| spelling | doaj.art-8509d9f6c2294f2faabbbae23658dc912023-11-20T10:44:12ZengWileyBioengineering & Translational Medicine2380-67612023-11-0186n/an/a10.1002/btm2.10565Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directionsJiahui Chen0Xiaoqi Tang1Ziyu Wang2Arielle Perez3Benjamin Yao4Ke Huang5Yang Zhang6Martin W. King7Department of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USADepartment of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USADepartment of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USAUNC School of Medicine Department of Surgery University of North Carolina Chapel Hill North Carolina USAMontefiore Medical Center Department of Obstetrics & Gynecology & Women's Health Services Montefiore Medical Center Bronx New York USAJoint Department of Biomedical Engineering North Carolina State University & University of North Carolina at Chapel Hill Raleigh North Carolina USADepartment of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USADepartment of Textile Engineering, Chemistry and Science North Carolina State University Raleigh North Carolina USAAbstract Postsurgical adhesions are a common complication of surgical procedures that can lead to postoperative pain, bowel obstruction, infertility, as well as complications with future procedures. Several agents have been developed to prevent adhesion formation, such as barriers, anti‐inflammatory and fibrinolytic agents. The Food and Drug Administration (FDA) has approved the use of physical barrier agents, but they have been associated with conflicting clinical studies and controversy in the clinical utilization of anti‐adhesion barriers. In this review, we summarize the human anatomy of the peritoneum, the pathophysiology of adhesion formation, the current prevention agents, as well as the current research progress on adhesion prevention. The early cellular events starting with injured mesothelial cells and incorporating macrophage response have recently been found to be associated with adhesion formation. This may provide the key component for developing future adhesion prevention methods. The current use of physical barriers to separate tissues, such as Seprafilm®, composed of hyaluronic acid and carboxymethylcellulose, can only reduce the risk of adhesion formation at the end stage. Other anti‐inflammatory or fibrinolytic agents for preventing adhesions have only been studied within the context of current research models, which is limited by the lack of in‐vitro model systems as well as in‐depth study of in‐vivo models to evaluate the efficiency of anti‐adhesion agents. In addition, we explore emerging therapies, such as gene therapy and stem cell‐based approaches, that may offer new strategies for preventing adhesion formation. In conclusion, anti‐adhesion agents represent a promising approach for reducing the burden of adhesion‐related complications in surgical patients. Further research is needed to optimize their use and develop new therapies for this challenging clinical problem.https://doi.org/10.1002/btm2.10565abdominal adhesionadhesion preventionanti‐adhesion strategyanti‐inflammatoryfibrinolytic agentphysical barrier |
| spellingShingle | Jiahui Chen Xiaoqi Tang Ziyu Wang Arielle Perez Benjamin Yao Ke Huang Yang Zhang Martin W. King Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions Bioengineering & Translational Medicine abdominal adhesion adhesion prevention anti‐adhesion strategy anti‐inflammatory fibrinolytic agent physical barrier |
| title | Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions |
| title_full | Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions |
| title_fullStr | Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions |
| title_full_unstemmed | Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions |
| title_short | Techniques for navigating postsurgical adhesions: Insights into mechanisms and future directions |
| title_sort | techniques for navigating postsurgical adhesions insights into mechanisms and future directions |
| topic | abdominal adhesion adhesion prevention anti‐adhesion strategy anti‐inflammatory fibrinolytic agent physical barrier |
| url | https://doi.org/10.1002/btm2.10565 |
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