All of the abdominal and pelvic organs - which are most susceptible to adhesions - are wrapped together in a clear membrane, the peritoneum. When this is traumatised by either infection or by surgery, aninflammatory response is triggered which stimulates growth of fibrous scar tissue.
Normally, these fibrous bands are absorbed by a process known as fibrinolysis, so that the site continues to heal. But by cutting through this delicate membrane or allowing the tissues to become dry and sticky, the biochemical process can be crippled.
This means that the fibrin bands continue to proliferate unchecked, forming attachments to nearby structures - typically causing damage such as strangling and blocking the bowel, or plugging the fallopian tubes, causing infertility.
"Think of what happens to cooked pasta if you drain it and allow it to dry out," says Michael Parker, a colorectal surgeon at Darent Valley Hospital in Dartford. (England)
"It gets sticky and will form a clump which you will find hard to separate. That's exactly what happens when adhesions get afoothold."
Gentle handling of the tissues during surgery, and the use of special anti-adhesion solutions and surgical barrier films during operations help prevent the occurrence of adhesions.
Even though a percentage of surgery patients will go on to develop adhesions, most of these will be dormant and won't cause problems. They may not be discovered until another operation is carried out - often years later.
