How do adhesions form?
All of the abdominal and pelvic organs except the ovaries are at least partially wrapped in a clear membrane called the peritoneum. When this membrane is traumatized during surgery, the site of the trauma becomes inflamed. Inflammation is normal and in fact is part of the healing process, but it also contributes to adhesion formation by encouraging the development of fibrous bands of scar tissue. Normally, these fibrin bands eventually dissolve through a biochemical process called “fibrinolysis,” and the traumatized site continues to heal. But sometimes the nature of the surgery results in decreased blood flow to these areas (ischemia). This ischemic condition can suppress the fibrinolysis. If the fibrin bands do not dissolve, they may develop into adhesions that connect pelvic organs or tissues that normally are separate.
