Adhesion prevention: state of the art

Objective To evaluate current and prospective methods of adhesion prevention. Design Review of published experimental and clinical studies of adhesion formation and prevention. Main outcome measures Reduction in de novo adhesions and adhesion re‐formation; cost to health care systems. Results Surgical technique influences adhesion formation. Laparoscopy reduces incisional and de novo adhesion formation. Pharmacological methods of adhesion prevention have not been adopted clinically. Three membrane barriers (two bioresorbable) are available to reduce adhesions. Liquid gels and solutions may have a role in non‐site‐specific adhesion prevention. New methods of adhesion prevention are being developed. Epidemiological studies show a large workload and health care cost associated with adhesion‐related disease. Conclusion Adhesion prevention is now possible using a variety of adhesion barriers in membrane and liquid/gel form. These may prove cost‐effective in reducing adhesion‐related disease. New products will soon be available.