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Human Reproduction Update, Vol.7, No.6 pp.556-566, 2001
© European Society of Human Reproduction and Embryology 2001; all rights reserved

Peritoneal healing and adhesion formation/reformation

Y. C. Cheong1, S. M. Laird1, T. C. Li1, J. B. Shelton1, W. L. Ledger1 and I. D. Cooke1

1 The Jessop Hospital for Women, Leavygreave Road, Sheffield S3 7RE, UK

To whom correspondence should be addressed at: T. C. Li, The Jessop Hospital for Women, Level 4, Room 126, The Jessop Wing, Tree Root Walk, Sheffield S10 2SF, UK. e-mail: yingcheong{at}hotmail.com

Abstract

Intra-abdominal adhesion formation and reformation after surgery is a cause of significant morbidity, resulting in infertility and pain. The understanding of the pathogenesis of adhesion formation and reformation especially at the cellular and molecular level can help to further develop more effective treatments for the prevention of adhesion formation and reformation. Following an injury to the peritoneum, fibrinolytic activity over the peritoneal surface decreases, leading to changes in the expression and synthesis of various cellular mediators and in the remodelling of the connective tissue. The cellular response to peritoneal injury and adhesion formation and reformation are reviewed. Analysis of the available literature data on the cellular mediators in the peritoneal fluid showed variation in results from different investigators. The potential sources of variability and error are examined. It is still unclear if there is significant individual variation in the peritoneal response to injury.

Key words: adhesion formation / cytokines / fibrinolysis / metalloproteinases / peritoneal fluid


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