Premium
Role of fibrinolysis in the formation of postoperative adhesions
Author(s) -
Holmdahl Lena E.,
AlJabreen Mohammed,
Risberg Bo
Publication year - 1994
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1046/j.1524-475x.1994.20306.x
Subject(s) - fibrinolysis , peritoneum , plasminogen activator , adhesion , medicine , tissue plasminogen activator , fibrin , t plasminogen activator , lesion , pathology , endocrinology , chemistry , immunology , organic chemistry
It has been hypothesized that peritoneal hypofibrinolysis is of importance in the formation of postoperative adhesions, but results from experiments with fibrinolytic modulators are conflicting. We tested this hypothesis in a controlled prospective study in rabbits, comparing the effects of fibrinolytic inhibition (tranexamic acid) to fibrinolysis enhancement by local instillation of gel containing tissue‐type plasminogen activator. Adhesion formation was measured after 1 week in a strictly standardized way and is presented as a percentage of an induced lesion that was covered by adhesions. Fibrinolytic inhibition significantly increased adhesion formation, both to the parietal peritoneum (34.2%± 3.2%) compared with untreated control (19.7%± 3.3%, p < 0.01) and to the bowel (76.3%± 5.8%) compared with untreated control (51.2%± 8.7%, p < 0.05). Control gel significantly increased adhesions to the parietal peritoneum (35.6%± 4.6%) versus untreated control (19.7%± 3.3%, p < 0.05), whereas gel containing tissue‐type plasminogen activator significantly reduced the amount of adhesions to the parietal peritoneum (4.9%± 1.7%) compared with untreated control (19.7%± 3.3%, p < 0.01) and abolished adhesion formation to the injured bowel. The fibrinolytic system thus seems to be intimately involved in the early formation of intraabdominal adhesions.