Controlling Peritoneal Adhesions

The normal peritoneum heals in five to seven days regardless of the size of the defect, because it does not heal by epithelial migration, as does skin, but heals by deposition of cells on the wound, or proliferation from within the wound depths. Adhesion formation provides vascular support to injured tissue and isolates contaminant substances. Adhesions are stimulated by serosal injury, tissue anoxia, or foreign material which act alone or in combination to inhibit locally the plasminogen‐plasmin (fibrinolytic) system. Proper surgical technique can reduce the formation of useless or pathological adhesions, or promote adhesions where desired, as with the antral tube gastropexy.