Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan

M. M.P.J. Reijnen, R. P. Bleichrodt, H. Van Goor

Research output: Contribution to journalReview articleAcademicpeer-review

106 Citations (Scopus)

Abstract

Background: Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan. Methods: Data were reviewed from the literature using the Medline database. Results: Both surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis. Conclusion: Diminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.

Original languageEnglish
Pages (from-to)533-541
Number of pages9
JournalBritish journal of surgery
Volume90
Issue number5
DOIs
Publication statusPublished - 1 May 2003
Externally publishedYes

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Abdominal Abscess
Hyaluronic Acid
Peritonitis
Abdominal Cavity
Fibrinolysis
Fibrin
Abscess
Sepsis
Databases
Morbidity
Mortality
Wounds and Injuries

Cite this

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title = "Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan",
abstract = "Background: Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan. Methods: Data were reviewed from the literature using the Medline database. Results: Both surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis. Conclusion: Diminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.",
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Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan. / Reijnen, M. M.P.J.; Bleichrodt, R. P.; Van Goor, H.

In: British journal of surgery, Vol. 90, No. 5, 01.05.2003, p. 533-541.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan

AU - Reijnen, M. M.P.J.

AU - Bleichrodt, R. P.

AU - Van Goor, H.

PY - 2003/5/1

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N2 - Background: Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan. Methods: Data were reviewed from the literature using the Medline database. Results: Both surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis. Conclusion: Diminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.

AB - Background: Intra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan. Methods: Data were reviewed from the literature using the Medline database. Results: Both surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis. Conclusion: Diminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.

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