Stages of adhesion development: A pathway for development of preventive strategy after abdominal surgery

Pathological bands formed between two surfaces within the body cavity as a result of surgical incision are termed as adhesions. Almost every abdominal, pelvis, peritoneal and thoracic surgery result in post-operative adhesions, the stages of forming thin film of connective tissue to thick fibrous adhesive bands is still unclear. Clinically silent post-operative adhesion result in reduced quality of life by having chronic abdominal pain, small bowel obstruction and even infertility leading to frequent hospitalizations. Planning a preventive strategy for the same requires detailed overview of different types of adhesions and time period required for developing certain forms of adhesion. Despite enormous clinical reviews and investigations there is no literature suggesting views and hypothesis of different stages of adhesion formation, this study will focus on various biomarkers, and mechanisms for defining a picture of different stages of adhesions. By understanding these stages and the underlying mechanism, targeted strategies for prevention and treatment can be made which ultimately help in improving patient outcomes and reduces the burden on healthcare systems. The study provides evidence for planning future studies on the basis of different stages of adhesion in pathological healing among subjects undergoing abdominal surgery to prevent them during the initial stages. • Prevention of adhesions is a matter of research for use in clinical practice and is been studied since a long time, no treatment for prevention is having a highly significant result. • Adhesiolysis leads to further adhesions formation and should be less preferred. • As the study defines stages of adhesion, it can be useful in developing various techniques for preventing adhesion at early stages and defining a gold standard diagnostic tool for assessing adhesions at early stage to predict the formation of adhesions. • Time dependent biomarkers can be used to assess the pathological healing.