%0 Journal Article
%T Peritoneal Response to Abdominal Surgery: The Role of Equine Abdominal Adhesions and Current Prophylactic Strategies
%A Juliana de Moura Alonso
%A Ana Liz Garcia Alves
%A Marcos Jun Watanabe
%A Celso Antonio Rodrigues
%A Carlos Alberto Hussni
%J Veterinary Medicine International
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/279730
%X Intra-abdominal adhesions constitute a significant clinical and surgical problem that can lead to complications such as pain and bowel occlusion or subocclusion. These adhesions are frustrating and potentially fatal, representing a major postoperative complication in abdominal surgery. It is estimated that 32% of horses undergoing laparotomy will present clinical symptoms due to adhesions, but the true prevalence is not known because a large proportion of animals with postoperative recurrent colics are medically treated or submitted to euthanasia without necropsy. Adhesions are highly cellular, vascularized, dynamic structures that are influenced by complex signaling mechanisms. Understanding their pathogenesis could assist in applying better therapeutic strategies and in developing more effective antiadhesion products. Currently, there are no definitive strategies that prevent adhesion formation, and it is difficult to interpret the results of existing studies due to nonstandardization of an induction model and evaluation of their severity. The best clinical results have been obtained from using minimally traumatic surgical techniques, anti-inflammatory agents, antimicrobials, anticoagulants, and mechanical separation of serosal surfaces by viscous intraperitoneal solutions or physical barriers. This paper aims to review adhesion formation pathogenesis, guide the understanding of major products and drugs used to inhibit adhesion formation, and address their effectiveness in the equine species. 1. Introduction Intra-abdominal adhesions in humans and animals constitute a significant clinical and surgical problem that can lead to complications such as pain, infertility, and bowel occlusion or subocclusion [1¨C4]. These adhesions also have high economic impacts due to surgical and hospital expenses [2, 5]. Adhesion formation is the most frequent cause of postoperative colic and the second most common cause of repeated celiotomy [6¨C8]. Therefore, they are an object of frustration for veterinary and human surgeons, which has stimulated research into products and methods to prevent their formation [9]. Although the trigger mechanisms of adhesion formation remain unclear, the possible causes are ischemia, surgical trauma, inflammation, hemorrhage, thermal or chemical injury, genetic predisposition, and reactions to foreign bodies [1, 5]. 2. Review 2.1. Adhesion Formation Mechanism The peritoneal membrane is embryologically derived from mesothelial cells. It is anchored in a basement membrane of submesothelial layer, the extracellular matrix (ECM). ECM consists
%U http://www.hindawi.com/journals/vmi/2014/279730/