New modalities under development for adhesion prevention: immunomodulatory agents and poloxamer barrier materials.
Obviously, no single modality will prove to be universally applicable or completely effective at preventing postoperative adhesion formation. Increasing understanding of the pathophysiology of peritoneal healing provides the intellectual basis for the development of specific interventions at critical points along the adhesion formation cascade. We believe that multimodality therapy, including the use of pharmacologic adjuvants such as immunomodulatory drugs and fibrinolytic/anticoagulant agents in conjunction with a barrier material tailored to the specific operative procedure may provide optimal results. Hopefully, developments in the 1990's will provide reproductive surgeons with the means to help patients derive maximal benefit from their reconstructive procedures.
Steinleitner
A
A
San Francisco Center for Reproductive Medicine, California Pacific Medical Center 94118.
Lambert
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H
Henderson
S
S
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000818:Animals; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D007247:Infertility, Female / Q000601:surgery*; D010431:Pentoxifylline / Q000627:therapeutic use; D010532:Peritoneal Diseases / Q000517:prevention & control*; D011060:Poloxalene / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D000267:Tissue Adhesions / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology*
D000276:Adjuvants, Immunologic; D002121:Calcium Channel Blockers; D011060:Poloxalene; D016285:Iloprost; D010431:Pentoxifylline