Postoperative adhesions are a problem that affects 1/3 of operated patients. How to prevent postoperative adhesions? We still disregard this problem in Poland. Currently, the most popular method of preventing postoperative adhesions is hyaluronic acid. See how postoperative adhesions are treated.
Postoperative adhesionsis a problem that is often neglected. In Poland,anti-growth prophylaxisis rarely used. There are two reasons for this - lack of money and neglect of the problem by both doctors and patients. And yet it is an important element of the effectiveness and success of surgical treatment. There are several ways to prevent adhesions.
Methods of preventing postoperative adhesions
By selecting the appropriate surgical technique, the doctor decides about the formation of smaller or larger adhesions after the procedure. It is worth adding that the adhesions formed after the first operation extend the duration of the next operation by at least 20 minutes.
- Mechanical barriers , preventing the formation of adhesions, is now a global trend in the fight against adhesion disease. After completion of the procedure, the surgeon introduces, for example, oxidized regenerated cellulose, Gore-Tex surgical membrane or fibrin foil, which biodegrades over time, between the operated tissues.
- Hyaluronic acidis currently considered the most popular anti-adhesion agent. This acid in the form of a gel is injected into the operated site. Due to its high viscosity, it creates a barrier in the operating field that prevents the contact of adjacent tissues, and thus protects the patient against adhesions. The preparation can be used for any type of surgery, regardless of the technique to be performed. After application on the surface of tissues, it creates the so-called 1 mm thick film and remains at the injection site for 7 days. This is important because adhesions usually form for about 5 days after surgery. Hyaluronic acid has no effect on the wound healing process. After 4 weeks from administration, it is completely biodegradable. When administered intraoperatively, it significantly reduces the frequency of new adhesions and prevents the enlargement of the existing ones. It also reduces the risk of adhesions resulting from the use of intraoperative sutures. Unfortunately, anti-growth prophylaxis is not reimbursed by the National He alth Fund. But possibleis to buy the appropriate gel yourself (cost approx. PLN 500) and hand it over to the surgeon who will apply it during the operation. However, this does not always solve the problem, as many doctors - and rightly so - are afraid of applying procedures not covered by the contract with the National He alth Fund. In Polish conditions, the risk of being accused of malpractice is very high, the growing wave of patients' claims against he alth care facilities does not encourage the use of additional procedures.
Therefore, it remains to wait until the European guidelines for the prevention of adhesions arising after general surgical and gynecological operations are taken into account by the National He alth Fund and introduced into common practice. For now, we can use anti-growth prophylaxis when undergoing procedures in private clinics.
Postoperative adhesions concern 1/3 of operated patients
The infamous statistics on the number of postoperative adhesions show that the problem should not be taken lightly.
- More than 1/3 of patients return to hospital after extensive open surgery within 10 years of surgery due to complications related to adhesions.
- After a new surgical intervention in 56% cases, there are complications.
- As many as 74 percent cases of intestinal obstruction are the result of postoperative adhesions.
- Adhesions are responsible for 20-40 percent. cases of secondary infertility in women.
- In the UK (no Polish data), the cost of adhesions-related readmissions to hospital is estimated at £ 24.2m after 2 years and £ 5.2m after 5 years after surgery.
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