الفهرس 
I. IntroductionOnly 14 pages are availabe for public view
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Abstract
Postoperative adhesions are the underlying etiology in 40 % of all cases of intestinal obstruction, which involve the small bowel in approximately 60–70 % of the cases. Other adhesion-related complications include female infertility, chronic pelvic pain, ureteral obstruction, and voiding dysfunction. The treatment of adhesion-related complications increases health care costs and reduces life quality of the patients because of the repeated hospitalization .
Ischemia at suture sites, infection, presence of a foreign body, and mechanical trauma from retractors and tissue handling are the major underlying etiologic factors.
Careful surgical technique, minimal tissue trauma, and good hemostasis, known as the principles of Halsted, have an important role in the prevention of postoperative adhesions. However, taking all these measures could not completely prevent the formation of adhesions. Unfortunately, no single method, which is universally accepted for the prevention of adhesions, could be determined until now, despite many experimental and clinical studies.
The key of preventing post-operative adhesions will most likely be based on selective inhibition of one or more of the critical factors required for their formation.Many chemical agents are used to inhibit this adhesion such as, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, calcium channel blockers, histamine antagonists, antibiotics, fibrinolytic agents, anticoagulants, antioxidants, hormones, vitamins, colchicines and selective immunosuppressors.
More recently, recombinant human tissue plasminogen activator has been evaluated for its effectiveness in prevention of post-operative adhesions. Numerous animal studies have demonstrated a significant decrease in the occurance of post- operative adhesions.