Attenuation Of Postoperative Adhesions Using A Modeled Manual Therapy (Data Files)

Abstract

These files include data and figures utilized to research and communicate the following: Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations, and represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. Based on the hypothesis that postoperative adhesions develop from a lack of movement of the abdominopelvic organs, we proposed a relatively simple treatment approach using a modified manual therapy technique that mobilizes abdominopelvic structures in the immediate postoperative period while they are otherwise rendered immobile by surgery and opiates. In a modified rat cecal abrasion model, we found that this treatment reduced the development of the most problematic type of adhesion. This effect was associated with a delay in the appearance of trophic macrophages. In a separate experiment using a strictureplasty model we showed that the treatment did not inhibit healing or induce undesirable complications. We can conclude that the treatment, which we have called modeled manual therapy, has potential as an effective preventive for postoperative adhesions. Our results support the hypothesis that maintained movements of the damaged structures can attenuate postoperative adhesion development, and lay the groundwork for further research, including mechanical and pharmacologic approaches