POSTOPERATIVE intestinal adhesions are the most common cause of small-bowel obstruction in the United States. Therefore, their prevention is desirable. While this goal is evident, the means of preventing adhesions are not. Elimination of operative trauma to the bowel which initiates the development of intestinal adhesions is often impossible. Should the intestinal serosa be abraded at operation, an inflammatory reaction begins minutes after injury. Within hours a fibrin exudate forms. The exudate undergoes organization, and fibroplasia is apparent as early as three to four days after injury. Fibroblast proliferation and collagen deposition lead to fibrous adhesions within ten days of operation. Maturation of adhesions proceeds rapidly up to 35 days after injury.1,2
Drugs which prevent clotting and lyse clots, act as lubricants, reduce inflammation, and inhibit fibroplasia have been employed in attempts to prevent intestinal adhesions, eg, steroids, antihistamines, heparin, amniotic fluid, mineral oil, lubricating jelly, fibrinolysin, dimethylsulfoxide, dextran,