Abstract
BackgroundAdhesions occur frequently after surgery. A number of methods are being employed for reducing post-operative adhesions. The purpose of this study was to determine the efficacy of hyaluronic acid gel in the reduction of post-operative bowel obstruction symptoms in patients undergoing emergency laparotomy due to small bowel perforation and presenting with peritonitis.MethodsIn this experimental study, 78 patients were evaluated. All had presented to the emergency department with peritonitis secondary to small bowel perforation. Exploratory laparotomy was performed and after thorough lavage, a loop stoma was formed on the right side of the abdomen with an injection of hyaluronic acid gel injected into the abdominal cavity before the closure of the abdomen. Postoperative obstructive symptoms at one, three, and six months were evaluated. All patients underwent stoma reversal at three months.ResultsObstructive bowel symptoms were seen in 18 patients (23.07%) patients. The cumulative incidence of obstructive symptoms at three months was only 8.97% but after the second intervention without protective gel, it increased to 23.07% at six months.ConclusionsCross-linked hyaluronic acid gel was effective in the reduction of post-operative bowel obstructive symptoms due to adhesions in patients who had presented with peritonitis due to small bowel perforation and had undergone exploratory laparotomy with stoma formation.
Highlights
Surgical adhesions are fibrotic bands that form between various structures of the abdominal cavity usually as a result of tissue trauma
Exploratory laparotomy was performed and after thorough lavage, a loop stoma was formed on the right side of the abdomen with an injection of hyaluronic acid gel injected into the abdominal cavity before the closure of the abdomen
Categories: General Surgery, Healthcare Technology Keywords: obstructive symptoms, laparotomy, peritonitis, small bowel perforation, hyaluronic acid gel Surgical adhesions are fibrotic bands that form between various structures of the abdominal cavity usually as a result of tissue trauma
Summary
Surgical adhesions are fibrotic bands that form between various structures of the abdominal cavity usually as a result of tissue trauma. Post-surgical adhesions may be thin or thick fibrous. Adhesions significantly increase the risk of hemorrhage, iatrogenic perforation, decreased view, and increased operative times during redo surgery. They are a major burden on the individual patient as well as the health care system [9]. The exact cause of adhesion formation post-surgery is still not exactly known, no definitive mechanisms to reduce adhesion formation have yet been developed [10]. The purpose of this study was to determine the efficacy of hyaluronic acid gel in the reduction of post-operative bowel obstruction symptoms in patients undergoing emergency laparotomy due to small bowel perforation and presenting with peritonitis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
